Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;51(5):517-527.
doi: 10.1111/hepr.13623. Epub 2021 Mar 9.

Clinical course of hepatitis C virus-positive patients with decompensated liver cirrhosis in the era of direct-acting antiviral treatment

Kazuki Maesaka  1 , Ryotaro Sakamori  1 , Ryoko Yamada  1 , Yuki Tahata  1 , Masahide Oshita  2 , Hideki Hagiwara  3 , Mitsuru Sakakibara  4 , Shinji Tamura  5 , Naoki Hiramatsu  6 , Masami Inada  7 , Sadaharu Iio  8 , Toshifumi Ito  9 , Takayuki Yakushijin  10 , Yoshinori Doi  11 , Takahiro Kodama  1 , Hayato Hikita  1 , Tomohide Tatsumi  1 , Tetsuo Takehara  1
Affiliations

Clinical course of hepatitis C virus-positive patients with decompensated liver cirrhosis in the era of direct-acting antiviral treatment

Kazuki Maesaka et al. Hepatol Res. 2021 May.

Abstract

Aim: The aim of the present study was to investigate the clinical course in hepatitis C virus (HCV)-positive patients with decompensated liver cirrhosis after direct-acting antivirals (DAAs) have been used for HCV infection.

Methods: This multicenter study prospectively analyzed a registered cohort composed of 73 HCV-positive patients with decompensated cirrhosis who attended our 11 institutions between January 2018 and July 2018. Prognoses, including changes in the liver reserve, hepatocellular carcinoma (HCC), decompensation events, and survival, were analyzed up to July 2020, as was the initiation of DAA treatment.

Results: Sixty-four (87.7%) and nine (12.3%) patients had Child-Pugh class (C-P) B and C at baseline, respectively. Within 2 years after enrollment, 17 patients (23.3%) received treatment with DAAs, and 31 patients (42.5%) developed uncontrolled HCC, switched to palliative care, or died. Patients who received DAA treatment were significantly younger and had significantly higher alanine aminotransferase levels and lower platelet counts than the patients who did not receive DAA treatment. The rates of overall survival, cumulative HCC occurrence, and cumulative hospitalization for any hepatic decompensation event at 2 years were 64.8%, 13.1%, and 65.6%, respectively. Overall survival was significantly shorter and the HCC occurrence and hospitalization rates were significantly higher in C-P C patients than in C-P B patients.

Conclusions: Among HCV-positive patients with decompensated cirrhosis, approximately one-fourth received DAA treatment, but more than 40% of the patients lost the opportunity for treatment with DAAs.

Keywords: Child-Pugh class; decompensated cirrhosis; direct-acting antiviral; hepatitis C virus; hepatocellular carcinoma.

PubMed Disclaimer

References

REFERENCES

    1. Ghany MG, Morgan TR. AASLD-IDSA hepatitis C guidance panel. Hepatitis C guidance 2019 update: American Association for the Study of Liver Diseases-Infectious Diseases Society of America recommendations for testing, managing, and treating hepatitis C virus infection. Hepatology. 2020;71:686-721.
    1. Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol. 2014;61:S58-68.
    1. World Health Organization. Hepatitis C fact sheet world Health Organization; 2017. https://www.who.int/en/news-room/fact-sheets/detail/hepatitis-c. Accessed 23 October 2020.
    1. The Japan Society of Hepatology (JSH). Guidelines for the management of hepatitis C virus infection: edition 8. 2020. full version [Japanese]. 2020. https://www.jsh.or.jp/files/uploads/HCV_GL_Cver8_20200716__2.pdf. Accessed October 23.
    1. Ito S, Goto T, Yahashi H, Kanto T, Yatsuhashi H, Tanaka J, et al. Investigation of actual condition of medical costs in liver cirrhosis and liver cancer patients due to hepatitis B or C infection for the Ministry of Health Labour and Welfare [Japanese]; 2016. [H28--002]. https://mhlw-grants.niph.go.jp/niph/search/NIDD00.do?resrchNum=201619007A. Accessed 23 October 2020.

LinkOut - more resources