Antiviral therapies generate survival rates over 90% in patients with HCV-related cirrhosis.
A recent study found that patients with hepatitis C virus (HCV) and related cirrhosis who respond well to antiviral therapy have similar survival rates to the general population.
Currently, international guidelines give higher priority for treatment with new direct antiviral agents to HCV patients who developed cirrhosis. According to a study published in the Journal of Hepatology, this recommendation is based on the positive outcomes of these patients with a sustained virologic response (SVR) after interferon-based treatment.
However, there have recently been some concerns about the evidence on which this recommendation is based on and if it’s substantial.
"The improved prognosis for patients who had a sustained virologic response has only been documented up to now by comparing patients who had such a response to interferon-based therapies with similar patients who were unsuccessfully treated, raising concerns about the real value of SVR as a reliable marker of disease outcome," said lead researcher Savino Bruno, MD.
Researchers analyzed prospective surveillance data from patients with HCV-related cirrhosis who received interferon-based therapy and achieved SVR, then compared them to patients with non-SVR, untreated, and decompensated patients.
The study included 795 patients with HCV-related cirrhosis administered interferon-based antiviral therapy, with 181 achieving SVR. Patients with HCV-compensated cirrhosis who achieved SVR had similar rates of death to the general population.
After 10 years, the survival rate was more than 90% and it was 63% after 20 years.
"These results confirm that patients who respond well to interferon-based therapies have a similar life expectancy to the general population, and suggest that treatment should be given as early as possible to patients with compensated HCV cirrhosis in order to achieve the highest benefit," concluded Dr Bruno. "Availability of interferon-free new direct antiviral agents (DAA) regimens will allow even sicker patients and those ineligible for interferon to achieve SVR, a major advance given that the mortality rate of these patients is extremely high in comparison to the general population. However, the overall impact of SVR needs to be assessed in further dedicated studies."