Scholarlink

Background/Aims <p>Direct-acting antivirals (DAAs) are highly effective in treating hepatitis C virus (HCV) infection. The long-term hepatic and extrahepatic outcomes of DAAs in chronic hepatitis C (CHC) patients receiving curative antivirals are elusive.</p> Methods <p>CHC patients were retrieved from two phase III sofosbuvir-based clinical trials conducted from 2013–2014. Patients who achieved a sustained virological response have been followed prospectively for 5 years since 2016. A propensity score-matched interferon-based historical control with a 1:3 ratio was used for comparison. Quality of life (QoL) was measured by the SF-36, liver fibrosis was measured by electrography, and fibrosis-related markers were followed annually in the prospective cohort.</p> Results <p>A total of 160 DAA- and 480 interferon-treated patients were enrolled. Twenty-eight patients developed hepatocellular carcinoma (HCC) over a follow-up period of 4424 person-years (annual incidence: 0.6%). The incidence of HCC did not differ significantly between the DAA cohort and interferon-treated patients (<i>P</i> = 0.07). Cox regression analysis revealed that FIB-4 was the only factor independently associated with HCC development (hazard ratio [HR]: 95% confidence interval [CI] 3.59/1.68–7.66, <i>P</i> = 0.001). The incidence of newly developed cardio-cerebrovascular disease was 13.8 per 1000 person-years and 0.9 per 1000 person-years in interferon-treated patients and the DAA cohort, respectively (<i>P</i> &lt; 0.001). Interferon-based patients had a significantly greater incidence of cardio-cerebrovascular disease (HR/CI 3.39/1.28–8.96, <i>P</i> = 0.014). There was a substantial decrease in liver stiffness (<i>P</i><sub>trend</sub> = 0.08) and M2BPGi (<i>P</i><sub>trend</sub> = 0.05) and a significant reduction in LOXL2 (<i>P</i><sub>trend</sub> = 0.02) over 5 years. A significant decrease in QoL was observed in role limitations due to physical health and emotional problems, whereas the other parameters were maintained consistently throughout the 5&#xa0;years of follow-up.</p> Conclusions <p>HCV eradication by DAAs improved liver- and non-liver-related outcomes, constantly promoted liver fibrosis regression, and maintained quality of life after HCV cure.</p> Clinical Trial Number <p>NCT03042520.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Long-Term Hepatic and Extrahepatic Outcomes of Chronic Hepatitis C Patients After Sofosbuvir-Based Treatment (LONGHEAD Study)

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月10日

查看全文
  • Chung-Feng Huang,
  • Jeong Heo,
  • Rong-Nan Chien,
  • Yang-Hyun Baek,
  • Jia-Horng Kao,
  • Ju-Hyun Kim,
  • Ting-Tsung Chang,
  • Kwan-Soo Byun,
  • Jyh-Jou Chen,
  • Sook-Hyang Jeong,
  • Tsung-Hui Hu,
  • Young-Seok Kim,
  • Cheng-Yuan Peng,
  • Won-Young Tak,
  • Horng-Yuan Wang,
  • Seung-Kew Yoon,
  • I.-Shyan Sheen,
  • Youn-Jae Lee,
  • Yu-Chun Hsu,
  • Hyung-Joon Yim,
  • Pei-Chien Tsai,
  • Ming-Lun Yeh,
  • Sang-Hoon Ahn,
  • Chia-Yen Dai,
  • Seung-Woon Paik,
  • Jee-Fu Huang,
  • Yoon-Jun Kim,
  • Wan-Long Chuang,
  • Young-Suk Lim,
  • Ming-Lung Yu

摘要

Background/Aims

Direct-acting antivirals (DAAs) are highly effective in treating hepatitis C virus (HCV) infection. The long-term hepatic and extrahepatic outcomes of DAAs in chronic hepatitis C (CHC) patients receiving curative antivirals are elusive.

Methods

CHC patients were retrieved from two phase III sofosbuvir-based clinical trials conducted from 2013–2014. Patients who achieved a sustained virological response have been followed prospectively for 5 years since 2016. A propensity score-matched interferon-based historical control with a 1:3 ratio was used for comparison. Quality of life (QoL) was measured by the SF-36, liver fibrosis was measured by electrography, and fibrosis-related markers were followed annually in the prospective cohort.

Results

A total of 160 DAA- and 480 interferon-treated patients were enrolled. Twenty-eight patients developed hepatocellular carcinoma (HCC) over a follow-up period of 4424 person-years (annual incidence: 0.6%). The incidence of HCC did not differ significantly between the DAA cohort and interferon-treated patients (P = 0.07). Cox regression analysis revealed that FIB-4 was the only factor independently associated with HCC development (hazard ratio [HR]: 95% confidence interval [CI] 3.59/1.68–7.66, P = 0.001). The incidence of newly developed cardio-cerebrovascular disease was 13.8 per 1000 person-years and 0.9 per 1000 person-years in interferon-treated patients and the DAA cohort, respectively (P < 0.001). Interferon-based patients had a significantly greater incidence of cardio-cerebrovascular disease (HR/CI 3.39/1.28–8.96, P = 0.014). There was a substantial decrease in liver stiffness (Ptrend = 0.08) and M2BPGi (Ptrend = 0.05) and a significant reduction in LOXL2 (Ptrend = 0.02) over 5 years. A significant decrease in QoL was observed in role limitations due to physical health and emotional problems, whereas the other parameters were maintained consistently throughout the 5 years of follow-up.

Conclusions

HCV eradication by DAAs improved liver- and non-liver-related outcomes, constantly promoted liver fibrosis regression, and maintained quality of life after HCV cure.

Clinical Trial Number

NCT03042520.