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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Kozbial, K; Moser, S; Al-Zoairy, R; Schwarzer, R; Datz, C; Stauber, R; Laferl, H; Strasser, M; Beinhardt, S; Stättermayer, AF; Gschwantler, M; Zoller, H; Maieron, A; Graziadei, I; Trauner, M; Steindl-Munda, P; Hofer, H; Ferenci, P.
Follow-up of sustained virological responders with hepatitis C and advanced liver disease after interferon/ribavirin-free treatment.
Liver Int. 2018; 38(6):1028-1035
Doi: 10.1111/liv.13629
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- Co-authors Med Uni Graz
- Stauber Rudolf
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- Abstract:
- The introduction of direct-acting antivirals (DAA) has increased sustained virological response (SVR) rates in patients with advanced liver disease and chronic hepatitis C(CHC)infection. At present, data on clinical outcome and long-term durability of viral eradication after successful DAA therapy are scarce. To evaluate the long-term success of viral eradication in patients with advanced fibrosis or cirrhosis treated with DAAs. Five hundred and fifty-one patients with advanced fibrosis (n = 158) or cirrhosis (CPS-A:317,CPS-B/C:76) and SVR after interferon and ribavirin-free DAA therapy treated between October 2013 and April 2016 were studied with a median follow-up of 65.6 (13.0-155.3) weeks. Only patients without hepatocellular carcinoma (HCC) at baseline and without liver transplantation were included. Twelve patients (2.2%) died during follow-up: the mortality rate was 0.6% in F3, 2.2% in CPS-A and 5.3% in CPS-B/C patients (P = .08). During follow-up 36 patients with cirrhosis (9.1%) developed a liver related event, including 16 with de-novo HCC (4.1%). Seven patients were transplanted at a median of 9.7 (range 3.8-21.7) months after EOT. History of decompensation was significantly associated with liver related events during follow-up (HR 7.9; 95% CI 2.7-22.6; P < .001), and with mortality (HR 5.5; 95% CI 1.5-20.2, P = .01). Eradication of HCV by DAA therapy was durable irrespective of the DAA combination used. Most of the cured patients had an excellent long-term clinical prognosis. Nevertheless, the risk of new occurrence of HCC remains worrisome and thus regular surveillance is obligatory even after clinical stabilization and improvement of the patient. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
- Find related publications in this database (Keywords)
- cirrhosis
- follow-up
- interferon-free treatment
- sustained virological response