Significant Mortality Benefit Seen With Sustained HCV Virologic Response With DAAs
Results suggest that achieving sustained virologic response using direct-acting antivirals in patients infected with hepatitis C without advanced liver disease may decrease mortality risk.
For patients infected with hepatitis C virus (HCV) without advanced liver disease, achieving sustained virologic response with direct-acting antivirals (DAAs) is associated with decreased mortality, according to results published in Hepatology.
The observational cohort included 103,346 patients mono-infected with HCV genotypes 1, 2, and 3 without advanced liver disease. Of these patients, 40,664 were treated with interferon-free DAAs, and the other 62,682 patients constituted the untreated cohort.
In the DAA-treated cohort, 96.8% of patients achieved sustained virologic response (n=39,374), and 3.2% did not (n=1290).
The mortality rate of patients who achieved sustained virologic response was 1.18 deaths/100 patient years compared with 2.84 deaths/100 patient years for patients who did not achieve sustained virologic response, and 3.84 deaths/100 patient years for untreated patients (P <.001).
After controlling for baseline demographics, clinical characteristics, and comorbidities, the researchers found that sustained virologic response was independently associated with reduced risk for death compared with patients who did not achieve sustained virologic response (hazard ratio, 0.44; 95% CI, 0.32-0.59; P <.001) and compared with untreated patients (HR, 0.32; 95% CI, 0.29-0.36; P <.001).
"Increasing access to DAAs for all HCV-infected individuals should result in fewer deaths," the researchers wrote.
Backus LI, Belperio PS, Shahoumian TA, Mole LA. Direct-acting antiviral sustained virologic response: impact on mortality in patients without advanced liver disease [published online January 29, 2018]. Hepatology. doi:10.1002/hep.29811