Benefits of Hepatitis C Viral Eradication: A Real-World Nationwide Cohort Study in Taiwan.
Journal
Digestive diseases and sciences
Journal Volume
69
Journal Issue
9
Pages
3501 - 3512
ISSN
1573-2568
Date Issued
2024-07-04
Author(s)
Chang, Chin-Wei
Hsu, Wei-Fan
Tseng, Kuo-Chih
Chen, Chi-Yi
Cheng, Pin-Nan
Hung, Chao-Hung
Lo, Ching-Chu
Bair, Ming-Jong
Lee, Pei-Lun
Lin, Chun-Yen
Kuo, Hsing-Tao
Yang, Chi-Chieh
Huang, Jee-Fu
Tai, Chi-Ming
et al.
Abstract
Background: Chronic hepatitis C (CHC) increases the risk of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). This nationwide cohort study assessed the effectiveness of viral eradication of CHC. Methods: The Taiwanese chronic hepatitis C cohort and Taiwan hepatitis C virus (HCV) registry are nationwide HCV registry cohorts incorporating data from 23 and 53 hospitals in Taiwan, respectively. This study included 27,577 individuals from these cohorts that were given a diagnosis of CHC and with data linked to the Taiwan National Health Insurance Research Database. Patients received either pegylated interferon and ribavirin or direct-acting antiviral agent therapy for > 4 weeks for new-onset LC and liver-related events. Results: Among the 27,577 analyzed patients, 25,461 (92.3%) achieved sustained virologic response (SVR). The mean follow-up duration was 51.2 ± 48.4 months, totaling 118,567 person-years. In the multivariable Cox proportional hazard analysis, the hazard ratio (HR) for incident HCC was 1.39 (95% confidence interval [CI]: 1.00–1.95, p = 0.052) among noncirrhotic patients without SVR compared with those with SVR and 1.82 (95% CI 1.34–2.48) among cirrhotic patients without SVR. The HR for liver-related events, including HCC and decompensated LC, was 1.70 (95% CI 1.30–2.24) among cirrhotic patients without SVR. Patients with SVR had a lower 10-year cumulative incidence of new-onset HCC than those without SVR did (21.7 vs. 38.7% in patients with LC, p < 0.001; 6.0 vs. 18.4% in patients without LC, p < 0.001). Conclusion: HCV eradication reduced the incidence of HCC in patients with and without LC and reduced the incidence of liver-related events in patients with LC. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.
Subjects
Chronic hepatitis C
Direct-acting antiviral agents
Hepatocellular carcinoma
Liver-related events
Taiwan hepatitis C virus registry
Type
journal article