Effect of sofosbuvir and velpatasvir therapy on clinical outcome in hepatitisC virus patients with decompensated cirrhosis.

Abstract

To determine the impact of direct-acting antiviral therapy on the long-term prognosis of decompensated cirrhotic patients. A total of 37 patients with hepatitisC virus-induced decompensated cirrhosis treated with sofosbuvir and velpatasvir (SOF/VEL group) were prospectively enrolled. For historical control, 65 hepatitisC virus-positive decompensated cirrhotic patients who did not receive direct-acting antiviral therapy were included (control group). The incidence rates of hepatocellular carcinoma (HCC), decompensated events with hospitalization, and overall survival were compared between both groups. A total of 41 patients experienced decompensated events during 15.0months in the control group, and six patients during 21.6months in the SOF/VEL group. The cumulative incidence rates of decompensated events after 2years were significantly higher in the control group (53.1%) than in the SOF/VEL group (14.5%; p<0.001). A total of 27 patients died within 22.0months in the control group, and three patients died within 25.6months in the SOF/VEL group. The overall survival rates after 2years were significantly lower in the control group (67.6%) than in the SOF/VEL group (91.3%; p=0.010). A total of 13 patients in the control group developed HCC during 15.8months, and 10 patients during 17.3months in the SOF/VEL group. The HCC incidence rates after 2years were 20.3% and 29.6% in the control and SOF/VEL groups, respectively, with no significant difference (p=0.327). SOF/VEL therapy may suppress the development of decompensated events and improve the prognosis in decompensated cirrhotic patients; however, the incidence of HCC remains prevalent in these patients irrespective of SOF/VEL therapy.