Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality

Yun Bin Lee, Joon Yeul Nam, Jeong Hoon Lee, Young Chang, Hyeki Cho, Young Youn Cho, Eun Ju Cho, Su Jong Yu, Hwi Young Kim, Dong Ho Lee, Jeong Min Lee, Seong Gyu Hwang, Yoon Jun Kim, Jung Hwan Yoon

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9 Scopus citations


Whether a sustained virological response (SVR) improves long-term outcomes in chronic hepatitis C patients with earlier-stage fibrosis has not been established. We investigated the differential effect of SVR on the risk of outcomes according to hepatic fibrosis grade. Fibrosis grade was categorised using FIB-4: <1.45, low-probability of significant fibrosis; 1.45–3.25, intermediate-probability; and ≥3.25, high-probability. Primary and secondary endpoints were hepatocellular carcinoma (HCC) occurrence and death, respectively. Among 1,373 included chronic hepatitis C patients, 744 patients were treated with interferon-based or –free regimens and 622 (83.6%) achieved SVR. SVR was independently associated with lower risk of HCC (vs. untreated: adjusted hazard ratio [aHR], 0.165; 95% confidence interval [CI], 0.077–0.350; P < 0.001) and overall death (vs. untreated; aHR, 0.146; 95% CI, 0.050–0.424; P < 0.001) during the median observation of 3.5 (interquartile range, 1.9–6.6) years. The SVR group had significantly lower risk of HCC than the untreated group among patients with intermediate-probability (n = 492: aHR, 0.171; 95% CI, 0.051–0.578; P = 0.004) and high-probability (n = 446: aHR, 0.243; 95% CI, 0.107–0.551; P < 0.001) of significant fibrosis. HRs were maintained after balancing with inverse probability weighting. SVR was associated with reduced risk of HCC development and all-cause mortality in patients with chronic hepatitis C.

Original languageEnglish
Article number13651
JournalScientific Reports
Issue number1
StatePublished - 1 Dec 2018

Bibliographical note

Funding Information:
This study was supported by grants from the National R&D Program for Cancer Control, Ministry for Health and Welfare, Republic of Korea (1420050), Liver Research Foundation of Korea as part of Bio Future Strategies Research Project, and Seoul National University Hospital (30–2016–0190).

Publisher Copyright:
© 2018, The Author(s).


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