%0 Journal Article
%T The Impact of Cirrhosis and History of Hepatocellular Carcinoma on All-Cause Mortality After Eradication of Hepatitis C Virus in Patients With Chronic Hepatitis C.
%A Toyoda H
%A Atsukawa M
%A Uojima H
%A Nozaki A
%A Takaguchi K
%A Hiraoka A
%A Itobayashi E
%A Watanabe T
%A Matsuura K
%A Shimada N
%A Abe H
%A Tsuji K
%A Itokawa N
%A Mikami S
%A Ishikawa T
%A Oikawa T
%A Yasuda S
%A Chuma M
%A Tsutsui A
%A Ikeda H
%A Arai T
%A Tsubota A
%A Kumada T
%A Tanaka Y
%A Tanaka J
%J Gastro Hep Adv
%V 1
%N 4
%D 2022
%M 39132067
暂无%R 10.1016/j.gastha.2022.02.018
%X UNASSIGNED: Cirrhosis and hepatocellular carcinoma (HCC) are potentially fatal complications of chronic hepatitis C virus (HCV) infection. We investigated how compensated cirrhosis and a history of curatively treated HCC influenced patient mortality after HCV eradication, that is, sustained virologic response (SVR).
UNASSIGNED: We studied 5458 patients with confirmed SVR who were prospectively followed up for more than 1 year after SVR achieved with direct-acting antivirals. Mortality and the incidence of HCC development after SVR were analyzed based on the presence or absence of compensated cirrhosis or a history of curatively treated HCC before the start of therapy.
UNASSIGNED: Mortality and the incidence of post-SVR HCC were significantly higher in patients with compensated cirrhosis and those with a history of curatively treated HCC than in those without these complications. Multivariate analysis showed that a history of HCC was associated with high mortality after SVR. In patients with no history of HCC, cirrhosis was associated with high mortality. Although both liver-related and nonliver-related mortality rates were significantly higher in patients with a history of HCC or cirrhosis, nonliver-related mortality did not differ based on HCC history, and liver-related and nonliver-related mortality were comparable regardless of cirrhosis after propensity score matching with age, gender, alcohol intake, and comorbidities.
UNASSIGNED: Mortality after SVR was significantly higher in patients with compensated cirrhosis or a history of HCC. While a history of HCC significantly increased mortality after SVR, even following curative treatment, the impact of pre-SVR compensated cirrhosis on post-SVR mortality was modest.