DAAs Improve Mortality Risk in Some With HCV

Achieving sustained virologic response (SVR) through direct-acting antiviral (DAA) treatment is associated with a significantly lowered risk of mortality in patients with hepatitis C virus (HCV) infection without advanced liver disease, a new study found.

For their study, the researchers evaluated 103,346 patients with genotypes 1, 2, or 3 HCV monoinfection without advanced liver disease. A total of 40,664 were treated with interferon-free DAA regimens, of whom 39,374 (96.8%) achieved SVR and 1290 (3.2%) patients did not. The remaining 62,682 patients were not treated.
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The mortality rate for patients who achieved SVR was found to be 1.18 deaths per 100 patient years, which was significantly lower than the rates for patients who did not achieve SVR (2.84 deaths per 100 patient years) and those who were not treated (3.84 deaths per 100 patient years).

Patients with Fibrosis-4 (FIB-4) scores of less than 1.45 and 1.45 to 3.25 who had achieved SVR demonstrated 46.0% and 63.2% decreases in mortality rates, respectively, vs patients who did not achieve SVR, and 66.7% and 70.6% decreases, respectively, vs patients who were not treated.

Ultimately, adjusted findings from multivariate Cox proportional hazards models indicated an independent association of SVR with a reduced risk of mortality compared with those who did not achieve SVR (hazard ratio [HR] 0.44) those who were not treated (HR 0.32).

“Successfully treating HCV with DAAs in patients without clinically apparent advanced liver disease translates into a significant mortality benefit,” the researchers concluded.

—Christina Vogt

Reference:

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.