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Benefits of Hepatitis C Viral Eradication: A Real-World Nationwide Cohort Study in Taiwan

  • 期刊论文

  • 发表日期：

    2024年7月4日

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

摘要

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.