Patients with chronic hepatitis C viral infection and cirrhosis can achieve a normal life expectancy if they attain a sustained virologic response with interferon-based antiviral therapy, according to a Research Letter published online Nov. 11 in JAMA.
Researchers performed a secondary analysis of data from a previous study involving consecutive patients with chronic HCV infection and biopsy-proven advanced hepatic fibrosis who initiated interferon during 1990-2003 at five large hepatology centers in Europe and Canada. A subgroup of 530 of these study participants was followed for a median of 8 years after completing the treatment, said Adriaan J. van der Meer, M.D., Ph.D., of the department of gastroenterology and hepatology, Erasmus University Medical Center, Rotterdam, and his associates.
The median patient age at baseline was 48 years. A total of 192 patients (36%) attained SVR.
Thirteen patients with SVR died during follow-up, yielding a cumulative 10-year overall survival of 91.1%. This did not differ significantly from survival in the age- and sex-matched general population, despite the study participants’ severe illness, the investigators reported (JAMA 2014;312:1927-8).
In contrast, 100 patients without SVR died during follow-up, for a cumulative 10-year survival of 74.0%. This was significantly lower than survival in the age- and sex-matched general population.
The “excellent” survival benefit of SVR for patients with advanced liver disease might be attributable to regression of hepatic inflammation and fibrosis; reduction of the hepatic venous pressure gradient; a decrease in the rate of hepatocellular carcinoma and liver failure; and a decreased incidence of diabetes, end-stage renal disease, and cardiovascular events, Dr. van der Meer and his associates said.
This study was funded by the Foundation for Liver and Gastrointestinal Research in Rotterdam. Dr. van der Meer reported having received compensation for previous work from Merck Sharp & Dohme and Gilead, and his associates reported ties to numerous industry sources.
