Article
Author: Cheng, Pin-Nan ; Hung, Chao-Hung ; Huang, Chung-Feng ; Chen, Chun-Ting ; Yang, Chi-Chieh ; Tsai, Pei-Chien ; Huang, Yi-Hsiang ; Chang, Shiuh-Nan ; Chong, Lee-Won ; Chang, Chun-Chao ; Dai, Chia-Yen ; Tsai, Ming-Chang ; Tsai, Wei-Lun ; Yeh, Ming-Lun ; Peng, Cheng-Yuan ; Yang, Sheng-Shun ; Chen, Chi-Yi ; Huang, Chien-Wei ; Hu, Jui-Ting ; Tai, Chi-Ming ; Hsieh, Tsai-Yuan ; Cheng, Chien-Yu ; Bair, Ming-Jong ; Lin, Chih-Lin ; Kao, Jia-Horng ; Huang, Jee-Fu ; Chuang, Wan-Long ; Lee, Tzong-Hsi ; Lin, Chih-Lang ; Lo, Ching-Chu ; Chen, Guei-Ying ; Lee, Pei-Lun ; Mo, Lein-Ray ; Liu, Chen-Hua ; Wang, Chia-Chi ; Tseng, Kuo-Chih ; Su, Wei-Wen ; Chang, Chin-Wei ; Yu, Ming-Lung ; Lin, Chun-Yen ; Chen, Chien-Hung ; Huang, Chia-Sheng ; Hsu, Shih-Jer ; Wang, Szu-Jen ; Lin, Chih-Wen ; Liu, Chun-Jen ; Lin, Han-Chieh ; Kuo, Hsing-Tao ; Hsu, Wei-Fan
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.