@article{226eb339f65744e782c93bd7d088bef9,
title = "Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality",
abstract = "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.",
author = "{Bin Lee}, Yun and Nam, {Joon Yeul} and Lee, {Jeong Hoon} and Young Chang and Hyeki Cho and Cho, {Young Youn} and Cho, {Eun Ju} and Yu, {Su Jong} and Kim, {Hwi Young} and Lee, {Dong Ho} and Lee, {Jeong Min} and Hwang, {Seong Gyu} and Kim, {Yoon Jun} and Yoon, {Jung Hwan}",
note = "Funding Information: Competing Interests: These authors disclose the following: Dr. Jung-Hwan Yoon reports receiving research grants from Bayer HealthCare Pharmaceuticals, Daewoong Pharmaceuticals, and Bukwang Pharmaceuticals; Dr. Yoon Jun Kim, research grants from Bristol-Myers Squibb, Roche, JW Creagene, Bukwang Pharmaceuticals, Handok Pharmaceuticals, Hanmi Pharmaceuticals, Yuhan Pharmaceuticals, Samjin Pharmaceuticals, and Pharmaking, and lecture fees from Bayer HealthCare Pharmaceuticals, Gilead Science, MSD Korea, Yuhan Pharmaceuticals, Samil Pharmaceuticals, CJ Pharmaceuticals, Bukwang Pharmaceuticals, and Handok Pharmaceuticals; Dr. Seong Gyu Hwang, research grants from Gilead Science and Dong-A ST; and Dr. Su Jong Yu, lecture fee from Bayer HealthCare Pharmaceuticals. No other potential conflict of interest relevant to this article was reported. Dr. Yun Bin Lee, Dr. Joon Yeul Nam, Dr. Jeong-Hoon Lee, Dr. Young Chang, Dr. Hyeki Cho, Dr. Young Youn Cho, Dr. Eun Ju Cho, Dr. Hwi Young Kim, Dr. Dong Ho Lee, and Dr. Jeong Min Lee report no conflict of interest. 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: {\textcopyright} 2018, The Author(s).",
year = "2018",
month = dec,
day = "1",
doi = "10.1038/s41598-018-31839-y",
language = "English",
volume = "8",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",
}