Liver and cardiovascular mortality after hepatitis C virus eradication by DAA: Data from RESIST‐HCV cohort

Abstract

Real-world evidence on the course of Hepatitis C Virus (HCV) chronic liver disease after Sustained Virologic Response (SVR) obtained with direct-acting antiviral drugs (DAAs) are still limited, and the effects on mortality remain unclear. We evaluated the post-treatment survival of 4307 patients in the RESIST-HCV cohort (mean age 66.3 ± 11.6 years, 56.9% males, 24.7% chronic hepatitis, 66.9% Child-PughThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Risk factors for liver‐related mortality of patients with hepatitis C virus after sustained virologic response to direct‐acting antiviral agents

“…The remaining cause of death was liver failure. 11 , 13 In contrast, our results were that 9 of 10 patients with liver‐related death died of liver cancer and only one patient died of liver failure. Therefore, it is considered that the reason for the difference in the results of this and the previous studies is the difference in the cause of liver‐related death.…”

“…In addition, patients with a history of HCC often have been excluded from such studies. 8 , 9 , 11 An Italian study included patients with a history of HCC and evaluated the association between the variables at the time of initiation of the final DAA therapy and liver‐related death. In that study, a significant association of liver‐related mortality with a history of HCC was observed by univariate analysis, but was not detected by multivariable analysis.…”

“… 7 In addition, a recent assessment of the survival benefit of SVR by DAA confirmed decreases in all‐cause and liver‐related mortality. 8 , 9 , 10 , 11 , 12 The French prospective cohort study showed that DAA treatment is associated with reduced risk for all‐cause mortality. Furthermore, that study reported a strong relation between all‐cause mortality and cirrhosis, markers of liver failure, and comorbidities (hypertension and anemia).…”

Cardiovascular Implications of Immune Disorders in Women

“…94 And finally, DAA-induced SVR has been associated with reduced cardiovascular mortality among men and women with HCV regardless of the presence of cirrhosis. 92 In sum, chronic HCV is associated with a higher burden of ASCVD risk factors, greater risk of ASCVD, and its associated adverse outcomes; however, data specific to women are severely lacking. Effective treatment of HCV appears to reduce the likelihood of ASCVD, particularly in women, further emphasizing its potential pathogenic role and highlighting the critical role of curative DAA treatment.…”

“…94 And finally, DAA-induced SVR has been associated with reduced cardiovascular mortality among men and women with HCV regardless of the presence of cirrhosis. 92…”