Viral eradication reduces all-cause mortality in patients with chronic hepatitis C virus infection who had received direct-acting antiviral therapy.

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Liver International Pub Date : 2024-09-02 DOI:10.1111/liv.16093

Toshifumi Tada, Masayuki Kurosaki, Hidenori Toyoda, Nobuharu Tamaki, Yutaka Yasui, Shinichiro Nakamura, Nami Mori, Keiji Tsuji, Hironori Ochi, Takehiro Akahane, Haruhiko Kobashi, Hideki Fujii, Hiroyuki Marusawa, Masahiko Kondo, Naohito Urawa, Hideo Yoshida, Yasushi Uchida, Atsuhiro Morita, Chitomi Hasebe, Akeri Mitsuda, Chikara Ogawa, Ryoichi Narita, Yoshihito Kubotsu, Tomomichi Matsushita, Masaya Shigeno, Eisuke Okamoto, Kazuhiko Okada, Toyotaka Kasai, Toru Ishii, Michiko Nonogi, Satoshi Yasuda, Yuichi Koshiyama, Takashi Kumada, Namiki Izumi

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Abstract

Background and aims: The impact of hepatitis C virus (HCV) eradication via direct-acting antiviral (DAA) therapy on overall mortality, particularly non-liver-related mortality, is understudied.

Methods: We recruited 4180 patients with chronic HCV infection who achieved sustained virological response (SVR) (HCV eradication) through DAA therapy (n = 2501, SVR group) or who did not receive antiviral therapy (n = 1679, non-SVR group); 1236 from each group were chosen using propensity score matching. Causes of death and all-cause mortality, including non-liver-related diseases, were investigated.

Results: Of the 4180 patients, 592 died during the follow-up period. In the SVR group, the mortality rates from liver-related and non-liver-related diseases were 16.5% and 83.5%, respectively. Compared to the non-SVR group, mortality rates from liver-related and non-liver-related diseases were 50.1% and 49.9%, respectively (p < .001). In non-cirrhotic patients, multivariable analysis revealed that SVR was an independent factor associated with both liver-related (hazard ratio [HR], .251; 95% confidence interval [CI], .092-.686) and non-liver-related (HR, .641; 95% CI, .415-.990) mortalities. In cirrhotic patients, multivariable analysis revealed that SVR remained an independent factor significantly associated with liver-related mortality (HR, .151; 95% CI, .081-.279). In propensity score-matched patients, the eradication of HCV (SVR group) decreased both liver-related (p < .001) and non-liver-related mortality (p = .008) rates compared to persistent HCV infection (non-SVR group).

Conclusions: The elimination of HCV via DAA therapy reduced not only liver-related mortality but also non-liver-related mortality in patients with chronic HCV.

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病毒根除可降低接受过直接作用抗病毒疗法的慢性丙型肝炎病毒感染患者的全因死亡率。

背景和目的：通过直接作用抗病毒疗法（DAA）根除丙型肝炎病毒（HCV）对总死亡率，尤其是非肝脏相关死亡率的影响尚未得到充分研究：我们招募了4180名慢性HCV感染患者，这些患者通过DAA疗法获得了持续病毒学应答（SVR）（HCV根除）（n = 2501，SVR组）或未接受抗病毒疗法（n = 1679，非SVR组）；采用倾向评分匹配法从每组中选择1236人。对死亡原因和全因死亡率（包括非肝脏相关疾病）进行了调查：结果：在 4180 名患者中，有 592 人在随访期间死亡。在 SVR 组中，肝脏相关疾病和非肝脏相关疾病的死亡率分别为 16.5% 和 83.5%。与非 SVR 组相比，肝脏相关疾病和非肝脏相关疾病的死亡率分别为 50.1%和 49.9%（P 结论）：通过 DAA 治疗消除 HCV 不仅降低了慢性 HCV 患者的肝脏相关死亡率，还降低了非肝脏相关死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.