Table 3.
Outcomes in cirrhosis after HCV SVR
| Study | Therapy | n | Followup | Outcome | Key finding(s) |
|---|---|---|---|---|---|
| Veldt (2007) (Ishak 4-6) | IFN based | 142 | 11 and 19 months | Clinical liver events | At the end of followup, there were 4 events in 142 patients with SVR and 83 events in 337 nonresponders |
| Mallet (2008) | IFN based | 96 | Median 17 months | Clinical liver events | Liver related death and complications were reduced in patients with SVR vs. those without, and in patients with cirrhosis regression vs. those without |
| Di Marco (2016) | IFN based | 106 | Median 7.6 years | Decompensating events, death | No patient without esophageal varices and an SVR (n = 67) developed a subsequent liver decompensation event. For death, 0.4% per year vs. 2.1% per year for non-SVR patients and 1.8% per year for SVR patients and 4.6% per year for non-SVR patients for patients without and with esophageal varices, respectively |
| Knop (2016) | DAA | 54 | 6 months | MELD | MELD was reduced from 9 to 8 during the followup period, bilirubin increased, and albumin increased |
| Belli (2016) | DAA | 103 | 60 weeks | MELD/CP | MELD was reduced by 3.4 points, CP reduced by 2 points |
| * Foster (2016) | DAA | 409 | 5 months | MELD | MELD (baseline = 11) was reduced by 0.85 MELD points in treated patients, and new decompensation events were reduced nearly 3 fold in treated patients compared to untreated controls |
| Martini (2017) | DAA (post transplant) | 72 | 6 months | Clinical liver events | (post-OLTx) Ascites resolved in 15 of 72 patients. Child Pugh score decreased, but there was no change in MELD score |
| Hill (2018) | DAA | 196 | 18 months | Clinical liver events | 29.1 hospitalizations per 100 person years in the control (HCV untreated) group compared to 10.4 hospitalizations per 100 person years in the DAA group |
| Janjua (2018) | IFN and DAA based | 1021 | 9.5/2 years | Clinical liver events | Reduction in mortality was similar among those with cirrhosis in both interferon (aHR=0.29, 95%CI:0.210.39) and DAA (aHR=0.28, 95%CI: 0.2-0.4) groups, respectively |
| Mauro (2018) | IFN based/DAA (post-OLTx) | 37 | 12 months | Clinical liver events | MELD declined from 10 to 9, and Child-Pugh score 6 to 5, bilirubin increased. Two of 37 patients had a decompensating event during followup, while 51% had a decompensating event at baseline |
| # Moon (2019) | DAA | 9399 | 3.1 years | Variceal bleeding | Variceal bleeding was reduced in cirrhotics with SVR compared to those without SVR (1.55 vs. 2.96 episodes per 100 patient years) |
| Prakash (2020) | DAA | 90 | 24 months | MELD | In patients with fibrosis regression, MELD decreased from 10 at baseline to 7, while in patients without fibrosis regression, MELD increased from 10 at baseline to 11. |
*
Included only decompensated patients, SVR rate of 81% in 409 patients
#
SVR in 7927