Long-term outcome of liver complications in patients with chronic HBV/HCV co-infection after antiviral therapy: a real-world nationwide study on Taiwanese Chronic Hepatitis C Cohort (T-COACH)
Journal
Hepatology International
Date Issued
2021
Author(s)
Yeh M.-L.
Hung C.-H.
Tseng K.-C.
Lai H.-C.
Chen C.-Y.
Kuo H.-T.
Wang J.-H.
Chen J.-J.
Lee P.-L.
Chien R.-N.
Yang C.-C.
Lo G.-H.
Tai C.-M.
Lin C.-W.
Yan S.-L.
Bair M.-J.
Lin C.-Y.
Su W.-W.
Chu C.-H.
Chen C.-J.
Tung S.-Y.
Lo C.-C.
Cheng P.-N.
Chiu Y.-C.
Wang C.-C.
Cheng J.-S.
Tsai W.-L.
Lin H.-C.
Huang Y.-H.
Huang C.-F.
Huang J.-F.
Dai C.-Y.
Chuang W.-L.
Tsai P.-C.
Peng C.-Y.
Yu M.-L.
Abstract
The long-term outcome of hepatitis B virus (HBV) infection among patients dually infected with HBV and hepatitis C virus (HCV) remains unclear. We aimed to investigate the long-term liver outcomes of HBV/HCV-coinfected patients after antiviral therapy. A total of 11,359 chronically HCV-infected patients with interferon-based therapy were registered in a nationwide Taiwanese Chronic Hepatitis C Cohort. A propensity score matched (PSM) cohort of HCV mono-infected (n = 7020) and HBV/HCV (n = 702) co-infected patients by age, sex, and fibrosis was recruited for outcome analysis. The primary outcome was liver-related complications, including hepatocellular carcinoma (HCC) and liver decompensation during a mean follow-up period of 4.44 years. Among HBV/HCV co-infected patients, patients without HCV-SVR had a significantly higher 10-year cumulative incidence of major liver-related complications than those with HCV-SVR. However, among patients with HCV-SVR in the PSM cohort, the risk of major liver-related complications, both HCC and liver decompensation, did not differ between HBV/HCV co-infected and HCV mono-infected patients. Similar results were observed among those without HCV-SVR. A substantial lower risk of major liver-related complications was found in HBV/HCV co-infected patients with HCV SVR and subsequent anti-HBV nucleot(s)ide analogues treatment. Overall, factors associated with major liver-related complications included age ≥ 65 year-old, BMI ≥ 27 kg/m2, FIB-4 ≥ 3.25, eGFR < 60 ml/min/1.73 m2, and non-HCV SVR, but not HBV co-infection. Interferon-based therapy reduced the long-term risk of major liver-related complications among HBV/HCV co-infected patients, as among HCV mono-infected patients. Nevertheless, post-HCV-SVR surveillance for major liver-related complications is mandatory among those high-risk groups.
SDGs
Publisher
Springer
Type
journal article