Title :

Clinical outcomes after treatment with direct antiviral agents: beyond the virological response in patients with previous HCV-related decompensated cirrhosis.

Author(s) :

Pageaux, Georges-Philippe [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Nzinga, Clovis Lusivika [Auteur]
Institut Pierre Louis d'Epidémiologie et de Santé Publique [iPLESP]
Ganne, Nathalie [Auteur]
Génomique fonctionnelle des tumeurs solides = Functional Genomics of Solid Tumors [CRC] [FunGeST]
Samuel, Didier [Auteur]
Physiopathogénèse et Traitement des Maladies du Foie [HEPAREG]
Dorival, Céline [Auteur]
Institut Pierre Louis d'Epidémiologie et de Santé Publique [iPLESP]
Zoulim, Fabien [Auteur]
Centre de Recherche en Cancérologie de Lyon [UNICANCER/CRCL]
Cagnot, Carole [Auteur]
ANRS France Recherche Nord & sud Sida-hiv hépatites
Decaens, Thomas [Auteur]
Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) [IAB]
Thabut, Dominique [Auteur]
Centre de Recherche Saint-Antoine [CRSA]
Asselah, Tarik [Auteur]
Centre de recherche sur l'Inflammation [CRI (UMR_S_1149 / ERL_8252 / U1149)]
Mathurin, Philippe [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Habersetzer, François [Auteur]
CIC Strasbourg [Centre d’Investigation Clinique Plurithématique (CIC - P)]
Bronowicki, Jean-Pierre [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Guyader, Dominique [Auteur]
Nutrition, Métabolismes et Cancer [NuMeCan]
Rosa, Isabelle [Auteur]
Centre Hospitalier Intercommunal de Créteil [CHIC]
Leroy, Vincent [Auteur]
Institut Mondor de Recherche Biomédicale [IMRB]
Chazouilleres, Olivier [Auteur]
CHU Saint-Antoine [AP-HP]
De Ledinghen, Victor [Auteur]
Bordeaux Research In Translational Oncology [Bordeaux] [BaRITOn]
Bourliere, Marc [Auteur]
Hôpital Saint-Joseph [Marseille]
Causse, Xavier [Auteur]
Centre Hospitalier Régional d'Orléans [CHRO]
Cales, Paul [Auteur]
Université d'Angers [UA]
Metivier, Sophie [Auteur]
Loustaud-Ratti, Véronique [Auteur]
Pharmacologie et Transplantation [P&T]
Riachi, Ghassan [Auteur]
Hôpital Charles Nicolle [Rouen]

Journal title :

BMC Infectious Diseases

Abbreviated title :

BMC Infect Dis

Volume number :

22

Pages :

94

Publication date :

2022-01-29

ISSN :

1471-2334

English keyword(s) :

Hepatitis C virus
Decompensated cirrhosis
Direst-acting antiviral agents
Survival
Hepatocellular carcinoma
Sustained virological response

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background In HCV-infected patients with advanced liver disease, the direct antiviral agents-associated clinical benefits remain debated. We compared the clinical outcome of patients with a previous history of decompensated ...
Show more >Background In HCV-infected patients with advanced liver disease, the direct antiviral agents-associated clinical benefits remain debated. We compared the clinical outcome of patients with a previous history of decompensated cirrhosis following treatment or not with direct antiviral agents from the French ANRS CO22 HEPATHER cohort. Methods We identified HCV patients who had experienced an episode of decompensated cirrhosis. Study outcomes were all-cause mortality, liver-related or non-liver-related deaths, hepatocellular carcinoma, liver transplantation. Secondary study outcomes were sustained virological response and its clinical benefits. Results 559 patients met the identification criteria, of which 483 received direct antiviral agents and 76 remained untreated after inclusion in the cohort. The median follow-up time was 39.7 (IQR: 22.7–51) months. After adjustment for multivariate analysis, exposure to direct antiviral agents was associated with a decrease in all-cause mortality (HR 0.45, 95% CI 0.24–0.84, p = 0.01) and non-liver-related death (HR 0.26, 95% CI 0.08–0.82, p = 0.02), and was not associated with liver-related death, decrease in hepatocellular carcinoma and need for liver transplantation. The sustained virological response was 88%. According to adjusted multivariable analysis, sustained virological response achievement was associated with a decrease in all-cause mortality (HR 0.29, 95% CI 0.15–0.54, p < 0.0001), liver-related mortality (HR 0.40, 95% CI 0.17–0.96, p = 0.04), non-liver-related mortality (HR 0.17, 95% CI 0.06–0.49, p = 0.001), liver transplantation (HR 0.17, 95% CI 0.05–0.54, p = 0.003), and hepatocellular carcinoma (HR 0.52, 95% CI 0.29–0.93, p = 0.03). Conclusion Treatment with direct antiviral agents is associated with reduced risk for mortality. The sustained virological response was 88%. Thus, direct antiviral agents treatment should be considered for any patient with HCV-related decompensated cirrhosis. Trial registration: ClinicalTrials.gov registry number: NCT01953458.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-12T02:23:05Z
2024-03-14T13:44:46Z