Clinical course of hepatitis C virus‐positive patients with decompensated liver cirrhosis in the era of direct‐acting antiviral treatment
| Autor: | Naoki Hiramatsu, Takayuki Yakushijin, Takahiro Kodama, Toshifumi Ito, Tetsuo Takehara, Kazuki Maesaka, Mitsuru Sakakibara, Yoshinori Doi, Masahide Oshita, Hideki Hagiwara, Shinji Tamura, Tomohide Tatsumi, Sadaharu Iio, Ryotaro Sakamori, Masami Inada, Ryoko Yamada, Yuki Tahata, Hayato Hikita |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Palliative care Cirrhosis Hepatology business.industry Hepatitis C virus medicine.disease_cause medicine.disease Gastroenterology Sofosbuvir/velpatasvir digestive system diseases Infectious Diseases Spontaneous bacterial peritonitis Model for End-Stage Liver Disease Internal medicine Hepatocellular carcinoma medicine Decompensation business |
| Zdroj: | Hepatology Research. 51:517-527 |
| ISSN: | 1872-034X 1386-6346 |
| DOI: | 10.1111/hepr.13623 |
| Popis: | Aim The aim of the present study was to investigate the clinical course in hepatitis C virus (HCV)-positive patients with decompensated liver cirrhosis after direct-acting antivirals (DAAs) have been used for HCV infection. Methods This multicenter study prospectively analyzed a registered cohort composed of 73 HCV-positive patients with decompensated cirrhosis who attended our 11 institutions between January 2018 and July 2018. Prognoses, including changes in the liver reserve, hepatocellular carcinoma (HCC), decompensation events and survival, were analyzed up to July 2020, as was the initiation of DAA treatment. Results Sixty-four (87.7%) and 9 (12.3%) patients had Child-Pugh class B and C at baseline, respectively. Within 2 years after enrollment, 17 patients (23.3%) received treatment with DAAs, and 31 patients (42.5%) developed uncontrolled HCC, switched to palliative care, or died. Patients who received DAA treatment were significantly younger and had significantly higher alanine aminotransferase levels and lower platelet counts than the patients who did not receive DAA treatment. The rates of overall survival (OS), cumulative HCC occurrence and cumulative hospitalization for any hepatic decompensation event at 2 years were 64.8%, 13.1% and 65.6%, respectively. OS was significantly shorter and the HCC occurrence and hospitalization rates were significantly higher in Child-Pugh class C patients than in Child-Pugh class B patients. Conclusions Among HCV-positive patients with decompensated cirrhosis, approximately one-fourth received DAA treatment, but more than 40% of the patients lost the opportunity for treatment with DAAs. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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