Scholarlink

Background <p>Long-term effects of direct-acting antiviral (DAA) on hepatic reserve and prognosis in hepatitis C virus (HCV)-related decompensated cirrhosis remain unclear.</p> Methods <p>Ninety-four patients from a follow-up study of the Japanese phase 3 trial of DAA treatment for decompensated cirrhosis were included.</p> Results <p>Twelve, seventy-seven, and ten percent of patients had Child–Pugh class A/B/C, respectively. The sustained virologic response (SVR) rate was 93.6%. The proportion of Child–Pugh A patients was 21% at end of treatment (EOT), and 40%, 42%, 49%, 40% at 24&#xa0;weeks, 1&#xa0;year, 3&#xa0;years, and 5&#xa0;years after EOT, respectively. A significant breakpoint for Child–Pugh class improvement to A was observed between 24&#xa0;weeks and 1&#xa0;year after EOT. The proportions of patients with albumin levels &gt; 3.5&#xa0;g/dl increased from 11% (baseline) to 39% (5&#xa0;years after EOT), and significant breakpoint for this improvement was observed between 12 and 24&#xa0;weeks after EOT. During the 4.8&#xa0;years from EOT, 19 patients died, and 1 underwent liver transplantation (LT). The five-year LT-free survival rate was 74.7%. Multivariate analysis identified virologic response and Child–Pugh class at 12&#xa0;weeks after EOT as significant LT-free survival predictors. The four-year LT-free survival rates were 91.5% for SVR patients and 33.3% for virologic failure patients.</p> Conclusions <p>In HCV-related decompensated cirrhosis, 5&#xa0;year LT-free survival rate after DAA was 74.7%, and viral clearance and post-treatment Child–Pugh class were associated with long-term prognosis. Child–Pugh class improved until 24&#xa0;weeks after EOT, but little change was observed thereafter, which was closely associated with albumin levels.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Long-term changes in hepatic reserve and prognosis after direct-acting antiviral treatment in patients with hepatitis C virus-related decompensated cirrhosis: a five-year follow-up study of a Japanese phase 3 trial

  • 期刊论文

  • 发表日期：

    2025年10月30日

查看全文
  • Yuki Tahata,
  • Hayato Hikita,
  • Akinobu Takaki,
  • Masayuki Kurosaki,
  • Kentaro Matsuura,
  • Hiroshi Yatsuhashi,
  • Hidekatsu Kuroda,
  • Yoshiyuki Ueno,
  • Shinya Maekawa,
  • Masato Nakamura,
  • Ryotaro Sakamori,
  • Takahiro Kodama,
  • Tetsuo Takehara

摘要

Background

Long-term effects of direct-acting antiviral (DAA) on hepatic reserve and prognosis in hepatitis C virus (HCV)-related decompensated cirrhosis remain unclear.

Methods

Ninety-four patients from a follow-up study of the Japanese phase 3 trial of DAA treatment for decompensated cirrhosis were included.

Results

Twelve, seventy-seven, and ten percent of patients had Child–Pugh class A/B/C, respectively. The sustained virologic response (SVR) rate was 93.6%. The proportion of Child–Pugh A patients was 21% at end of treatment (EOT), and 40%, 42%, 49%, 40% at 24 weeks, 1 year, 3 years, and 5 years after EOT, respectively. A significant breakpoint for Child–Pugh class improvement to A was observed between 24 weeks and 1 year after EOT. The proportions of patients with albumin levels > 3.5 g/dl increased from 11% (baseline) to 39% (5 years after EOT), and significant breakpoint for this improvement was observed between 12 and 24 weeks after EOT. During the 4.8 years from EOT, 19 patients died, and 1 underwent liver transplantation (LT). The five-year LT-free survival rate was 74.7%. Multivariate analysis identified virologic response and Child–Pugh class at 12 weeks after EOT as significant LT-free survival predictors. The four-year LT-free survival rates were 91.5% for SVR patients and 33.3% for virologic failure patients.

Conclusions

In HCV-related decompensated cirrhosis, 5 year LT-free survival rate after DAA was 74.7%, and viral clearance and post-treatment Child–Pugh class were associated with long-term prognosis. Child–Pugh class improved until 24 weeks after EOT, but little change was observed thereafter, which was closely associated with albumin levels.