Abstract
Background and Objectives: Direct-acting antiviral agents (DAAs) have improved sustained virologic response (SVR) rates in patients with chronic hepatitis C virus (HCV) infection. Our aim was to elucidate the occurrence of hepatocellular carcinoma (HCC) and to compare the outcomes of patients aged 75 years or older (older group) with those of patients younger than 75 years (younger group) after SVR. Materials and Methods: Among 441 patients treated with interferon-free DAA combinations, a total of 409 SVR patients were analyzed. We compared the two age groups in terms of HCC incidence and mortality rates. Results: Older and younger groups consisted of 68 and 341 patients, respectively. Occurrence of HCC after SVR did not differ between the two groups of patients with a history of HCC. Occurrence of HCC after SVR was observed more in younger patients without a history of HCC (p < 0.01). Although older patients without a history of HCC had a higher mortality rate (p < 0.01), their causes of death were not associated with liver diseases. Among younger patients without a history of HCC, none died. Conclusions: After SVR, liver disease may not be a prognostic factor in older HCV patients without a history of HCC.
Highlights
The administration of an interferon-free combination of direct-acting antiviral agents (DAAs) with or without ribavirin allows us to achieve higher sustained virologic response (SVR) rates in hepatitis C virus (HCV) infected patients with fewer side effects than prior interferon-including regimens [1,2]
We previously reported on the efficacy and outcomes of Japanese patients with genotype 2a or 2b HCV infection treated with sofosbuvir/ribavirin combination therapy in
We especially focused on the incidence of hepatocellular carcinoma (HCC) and showed that regular screening for HCC is needed in HCV patients after SVR
Summary
The administration of an interferon-free combination of direct-acting antiviral agents (DAAs) with or without ribavirin allows us to achieve higher sustained virologic response (SVR) rates in hepatitis C virus (HCV) infected patients with fewer side effects than prior interferon-including regimens [1,2]. Direct-acting antiviral agents (DAAs) have improved sustained virologic response (SVR) rates in patients with chronic hepatitis C virus (HCV) infection. Occurrence of HCC after SVR did not differ between the two groups of patients with a history of HCC. Older patients without a history of HCC had a higher mortality rate (p < 0.01), their causes of death were not associated with liver diseases. Conclusions: After SVR, liver disease may not be a prognostic factor in older HCV patients without a history of HCC
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