Posttreatment liver function, but not baseline liver function stratifies patient survival after direct-acting antiviral treatment in decompensated cirrhosis with hepatitis C virus
© 2023. The Author(s)..
BACKGROUND: The prognosis of cirrhosis is clearly stratified by liver function. Although direct-acting antiviral (DAA) has recently been used to eliminate hepatitis C virus (HCV), it is not clear whether liver function stratifies the prognosis of decompensated cirrhotic patients treated with DAA.
METHODS: A total of 206 HCV-associated decompensated cirrhotic patients who started DAA from February 2019 to December 2021 at 31 Japanese hospitals were prospectively registered.
RESULTS: The median age was 68, and the proportions of patients with Child-Pugh class A (CP-A), CP-B and CP-C were 10% (20/206), 76% (156/206) and 15% (30/206), respectively. Twenty-six patients died, and two patients underwent liver transplantation (LT); the 2- and 3-year LT-free survival rates were 90.0% and 83.2%, respectively. We examined factors associated with LT-free survival using 2 models including either CP class (Model 1) or MELD score (Model 2). In multivariate Cox proportional hazard analysis, CP class at 12 weeks after the end of treatment (EOT) in Model 1 and MELD score at 12 weeks after the EOT in Model 2 were significant factors, while baseline CP class or MELD score was not. Two-year LT-free survival rates were 100%, 91.6% and 60.4% for patients with CP-A, CP-B and CP-C at 12 weeks after the EOT and 95.2% and 69.6% for patients with MELD < 15 and MELD ≥ 15 at 12 weeks after the EOT, respectively.
CONCLUSIONS: The prognosis of decompensated cirrhotic patients receiving DAA was stratified by liver function at 12 weeks after the EOT, not by baseline liver function.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:58 |
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| Enthalten in: |
Journal of gastroenterology - 58(2023), 12 vom: 13. Dez., Seite 1211-1221 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tahata, Yuki [VerfasserIn] |
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| Links: |
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| Themen: |
Antiviral Agents |
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| Anmerkungen: |
Date Completed 27.11.2023 Date Revised 28.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00535-023-02039-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM363241485 |
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| 100 | 1 | |a Tahata, Yuki |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Posttreatment liver function, but not baseline liver function stratifies patient survival after direct-acting antiviral treatment in decompensated cirrhosis with hepatitis C virus |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 27.11.2023 | ||
| 500 | |a Date Revised 28.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: The prognosis of cirrhosis is clearly stratified by liver function. Although direct-acting antiviral (DAA) has recently been used to eliminate hepatitis C virus (HCV), it is not clear whether liver function stratifies the prognosis of decompensated cirrhotic patients treated with DAA | ||
| 520 | |a METHODS: A total of 206 HCV-associated decompensated cirrhotic patients who started DAA from February 2019 to December 2021 at 31 Japanese hospitals were prospectively registered | ||
| 520 | |a RESULTS: The median age was 68, and the proportions of patients with Child-Pugh class A (CP-A), CP-B and CP-C were 10% (20/206), 76% (156/206) and 15% (30/206), respectively. Twenty-six patients died, and two patients underwent liver transplantation (LT); the 2- and 3-year LT-free survival rates were 90.0% and 83.2%, respectively. We examined factors associated with LT-free survival using 2 models including either CP class (Model 1) or MELD score (Model 2). In multivariate Cox proportional hazard analysis, CP class at 12 weeks after the end of treatment (EOT) in Model 1 and MELD score at 12 weeks after the EOT in Model 2 were significant factors, while baseline CP class or MELD score was not. Two-year LT-free survival rates were 100%, 91.6% and 60.4% for patients with CP-A, CP-B and CP-C at 12 weeks after the EOT and 95.2% and 69.6% for patients with MELD < 15 and MELD ≥ 15 at 12 weeks after the EOT, respectively | ||
| 520 | |a CONCLUSIONS: The prognosis of decompensated cirrhotic patients receiving DAA was stratified by liver function at 12 weeks after the EOT, not by baseline liver function | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Child–Pugh score | |
| 650 | 4 | |a DAA | |
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| 650 | 4 | |a Velpatasvir | |
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| 700 | 1 | |a Mochida, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Enomoto, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Ido, Akio |e verfasserin |4 aut | |
| 700 | 1 | |a Kuroda, Hidekatsu |e verfasserin |4 aut | |
| 700 | 1 | |a Miki, Daiki |e verfasserin |4 aut | |
| 700 | 1 | |a Kurosaki, Masayuki |e verfasserin |4 aut | |
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| 700 | 1 | |a Suda, Goki |e verfasserin |4 aut | |
| 700 | 1 | |a Yatsuhashi, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshiji, Hitoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kato, Naoya |e verfasserin |4 aut | |
| 700 | 1 | |a Takami, Taro |e verfasserin |4 aut | |
| 700 | 1 | |a Nakao, Kazuhiko |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuura, Kentaro |e verfasserin |4 aut | |
| 700 | 1 | |a Asahina, Yasuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Itoh, Yoshito |e verfasserin |4 aut | |
| 700 | 1 | |a Tateishi, Ryosuke |e verfasserin |4 aut | |
| 700 | 1 | |a Nakamoto, Yasunari |e verfasserin |4 aut | |
| 700 | 1 | |a Kakazu, Eiji |e verfasserin |4 aut | |
| 700 | 1 | |a Terai, Shuji |e verfasserin |4 aut | |
| 700 | 1 | |a Shimizu, Masahito |e verfasserin |4 aut | |
| 700 | 1 | |a Ueno, Yoshiyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Akuta, Norio |e verfasserin |4 aut | |
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| 700 | 1 | |a Moriuchi, Akihiro |e verfasserin |4 aut | |
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