Dr Pierre Nahon and colleagues from France performed a prospective study to investigate the effects of a sustained viral response on outcomes of patients with hepatitis C virus (HCV) infection and compensated cirrhosis.
The researchers collected data from 1323 patients included in the prospective Agence Nationale pour la Recherche sur le SIDA et les hépatites virales (ANRS) viral cirrhosis (CirVir) cohort, recruited from 35 clinical centers in France from 2006 through 2012.
All patients had HCV infection and biopsy-proven cirrhosis, were Child–Pugh class A, and had no prior liver complications.
|51% of patients achieved sustained viral response|
All patients received anti-HCV treatment before or after inclusion, and underwent an ultrasound examination every 6 months, as well as endoscopic evaluations.
The team considered sustained viral response as a time-dependent covariate.
After a median follow-up period of 58 months, the researchers reported that 51% of patients achieved sustained viral response.
The research team found that sustained viral response was associated with a decreased incidence of hepatocellular carcinoma, and hepatic decompensation.
The team observed that patients with sustained viral responses also had a lower risk of cardiovascular events, and bacterial infections.
Metabolic features were associated with a higher risk of hepatocellular carcinoma in patients with sustained viral responses, but not in patients with viremia.
The team noted that sustained viral response affected overall mortality, and death from liver-related and non–liver-related causes.
Similar results were obtained in a propensity score-matched population.
Dr Nahon's team concludes, "We confirmed a reduction in critical events, liver-related or not, in a prospective study of patients with HCV infection and compensated cirrhosis included in the CirVir cohort who achieved an sustained viral response."
"We found an sustained viral response to reduce overall mortality, and risk of death from liver-related and non–liver-related causes."
"A longer follow-up evaluation is required to accurately describe and assess specific risk factors for complications in this population."