4.4 Article

Lower Incidence of Hepatocellular Carcinoma and Cirrhosis in Hepatitis C Patients with Sustained Virological Response by Pegylated Interferon and Ribavirin

Journal

DIGESTIVE DISEASES AND SCIENCES
Volume 60, Issue 2, Pages 573-581

Publisher

SPRINGER
DOI: 10.1007/s10620-014-3361-6

Keywords

Hepatitis C; Cirrhosis; Hepatocellular carcinoma; Antiviral therapy; Sustained virological response

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To elucidate the benefits of successful antiviral therapy in chronic hepatitis C (CHC) patients A total of 463 CHC patients who underwent pegylated interferon alfa and ribavirin therapy were classified as sustained virological response (SVR) or non-SVR based on response to antiviral therapy. We investigated disease progression to cirrhosis in non-cirrhotic patients, development of cirrhosis-related complications such as ascites, variceal bleeding, and hepatic encephalopathy in patients with cirrhosis, and development of hepatocellular carcinoma (HCC). Three hundred patients achieved SVR, and 163 were classified into the non-SVR group. The overall SVR rates were 64.8 %, and multivariate analysis showed that younger age, non-cirrhosis, HCV genotype 2 or 3, lower HCV RNA level (< 800,000 IU/mL), and lower body weight were independent factors associated with SVR (all P < 0.05). During a median follow-up of 36.1 months, non-cirrhotic patients with SVR had significantly lower risk of progression to cirrhosis compared with patients with non-SVR (P < 0.001). Moreover, SVR was related to a reduced risk of HCC development (P = 0.017). SVR resulted in significantly more favorable long-term outcomes, such as lower risk of progression to cirrhosis and HCC occurrence compared with non-SVR.

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