Association Between Sustained Virological Response and All-Cause Mortality Among Patients With Chronic Hepatitis C and Advanced Hepatic Fibrosis

Adriaan van der Meer, Bart Veldt, JJ Feld, H Wedemeyer, JF Dufour, F Lammert, A Duarte-Rojo, EJ Heathcote, MP Manns, L Kuske, S Zeuzem, WP Hofmann, Rob de Knegt, Bettina Hansen, HLA Janssen

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Abstract

Context Chronic hepatitis C virus (HCV) infection outcomes include liver failure, hepatocellular carcinoma (HCC), and liver-related death. Objective To assess the association between sustained virological response (SVR) and all-cause mortality in patients with chronic HCV infection and advanced hepatic fibrosis. Design, Setting, and Patients An international, multicenter, long-term follow-up study from 5 large tertiary care hospitals in Europe and Canada of 530 patients with chronic HCV infection who started an interferon-based treatment regimen between 1990 and 2003, following histological proof of advanced hepatic fibrosis or cirrhosis (Ishak score 4-6). Complete follow-up ranged between January 2010 and October 2011. Main Outcome Measures All-cause mortality. Secondary outcomes were liver failure, HCC, and liver-related mortality or liver transplantation. Results The 530 study patients were followed up for a median (interquartile range [IQR]) of 8.4 (6.4-11.4) years. The baseline median (IQR) age was 48 (42-56) years and 369 patients (70%) were men. The Ishak fibrosis score was 4 in 143 patients (27%), Sin 101 patients (19%), and 6 in 286 patients (54%). There were 192 patients (36%) who achieved SVR; 13 patients with SVR and 100 without SVR died (10-year cumulative all-cause mortality rate, 8.9% [95% Cl, 3.3%-14.5%] with SVR and 26.0% [95% Cl, 2 Conclusion Among patients with chronic HCV infection and advanced hepatic fibrosis, sustained virological response to interferon-based treatment was associated with lower all-cause mortality. JAMA. 2012;308(24):2584-2593 www.jama.com
Original languageUndefined/Unknown
Pages (from-to)2584-2593
Number of pages10
JournalJAMA - Journal of the American Medical Association
Volume308
Issue number24
DOIs
Publication statusPublished - 2012

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