☆ 4.5 Article

Clinical course of hepatitis C virus-positive patients with decompensated liver cirrhosis in the era of direct-acting antiviral treatment

HEPATOLOGY RESEARCH (2021)

期刊

HEPATOLOGY RESEARCH

卷 51, 期 5, 页码 517-527

出版社

WILEY

DOI: 10.1111/hepr.13623

关键词

Child– Pugh class; decompensated cirrhosis; direct‐ acting antiviral; hepatitis C virus; hepatocellular carcinoma

类别

Gastroenterology & Hepatology

资金

Gilead Sciences
Japan Agency for Medical Research and Development [JP20fk0210058]

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摘要

The study aimed to investigate the clinical course in HCV-positive patients with decompensated liver cirrhosis after DAAs treatment. Approximately one-fourth of the patients received DAA treatment, but more than 40% lost the opportunity for it. Overall survival was significantly shorter and the HCC occurrence and hospitalization rates were higher in C-P C patients than in C-P B patients.

Aim The aim of the present study was to investigate the clinical course in hepatitis C virus (HCV)-positive patients with decompensated liver cirrhosis after direct-acting antivirals (DAAs) have been used for HCV infection. Methods This multicenter study prospectively analyzed a registered cohort composed of 73 HCV-positive patients with decompensated cirrhosis who attended our 11 institutions between January 2018 and July 2018. Prognoses, including changes in the liver reserve, hepatocellular carcinoma (HCC), decompensation events, and survival, were analyzed up to July 2020, as was the initiation of DAA treatment. Results Sixty-four (87.7%) and nine (12.3%) patients had Child-Pugh class (C-P) B and C at baseline, respectively. Within 2 years after enrollment, 17 patients (23.3%) received treatment with DAAs, and 31 patients (42.5%) developed uncontrolled HCC, switched to palliative care, or died. Patients who received DAA treatment were significantly younger and had significantly higher alanine aminotransferase levels and lower platelet counts than the patients who did not receive DAA treatment. The rates of overall survival, cumulative HCC occurrence, and cumulative hospitalization for any hepatic decompensation event at 2 years were 64.8%, 13.1%, and 65.6%, respectively. Overall survival was significantly shorter and the HCC occurrence and hospitalization rates were significantly higher in C-P C patients than in C-P B patients. Conclusions Among HCV-positive patients with decompensated cirrhosis, approximately one-fourth received DAA treatment, but more than 40% of the patients lost the opportunity for treatment with DAAs.

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Posttreatment liver function, but not baseline liver function stratifies patient survival after direct-acting antiviral treatment in decompensated cirrhosis with hepatitis C virus

Yuki Tahata, Hayato Hikita, Satoshi Mochida, Nobuyuki Enomoto, Akio Ido, Hidekatsu Kuroda, Daiki Miki, Masayuki Kurosaki, Yoichi Hiasa, Ryotaro Sakamori, Norifumi Kawada, Taro Yamashita, Goki Suda, Hiroshi Yatsuhashi, Hitoshi Yoshiji, Naoya Kato, Taro Takami, Kazuhiko Nakao, Kentaro Matsuura, Yasuhiro Asahina, Yoshito Itoh, Ryosuke Tateishi, Yasunari Nakamoto, Eiji Kakazu, Shuji Terai, Masahito Shimizu, Yoshiyuki Ueno, Norio Akuta, Masanori Miyazaki, Yasutoshi Nozaki, Masayuki Kabayama, Satoshi Sobue, Akihiro Moriuchi, Tomokatsu Miyaki, Takahiro Kodama, Tomohide Tatsumi, Tomomi Yamada, Tetsuo Takehara

Summary: This study aims to analyze the prognosis of decompensated cirrhotic patients with HCV infection receiving DAA treatment and explore the stratification effect of liver function on prognosis.

JOURNAL OF GASTROENTEROLOGY (2023)