The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University, Zhenjiang, China.
Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
Sci Rep. 2024 Oct 10;14(1):23760. doi: 10.1038/s41598-024-75280-w.
The long-term benefits of direct-acting antiviral (DAA) therapy after achieving sustained virological response (SVR) remain uncertain in the Chinese population. This study evaluates the incidence of hepatocellular carcinoma (HCC), hepatic decompensation, and all-cause mortality among Chinese hepatitis C patients treated with DAAs. We included patients diagnosed since 2011 and followed them until November 1, 2022. The primary outcomes were HCC, hepatic decompensation, and mortality. Multivariable proportional hazards model was used to assess the impact of SVR and cirrhosis status. The cohort consisted of 1272 patients with SVR (92.1%) and 109 without SVR (7.9%), with a median follow-up of 61 months. The incidence of HCC was significantly lower in the SVR group (5.1 per 1000 person-years) compared to the no-SVR group (15.0 per 1000 person-years). Achieving SVR was associated with a significantly reduced risk of HCC (adjusted hazard ratio: 0.32; 95% CI 0.16-0.67). Cirrhosis was linked to an increased risk of developing HCC and hepatic decompensation. These findings highlight the importance of early DAA treatment, particularly for patients with cirrhosis.
直接作用抗病毒（DAA）治疗在获得持续病毒学应答（SVR）后的长期获益在中国人群中仍不确定。本研究评估了 DAA 治疗的中国丙型肝炎患者中肝细胞癌（HCC）、肝功能失代偿和全因死亡率的发生率。我们纳入了自 2011 年以来诊断的患者，并随访至 2022 年 11 月 1 日。主要结局是 HCC、肝功能失代偿和死亡率。多变量比例风险模型用于评估 SVR 和肝硬化状态的影响。该队列包括 1272 例 SVR 患者（92.1%）和 109 例未 SVR 患者（7.9%），中位随访时间为 61 个月。SVR 组 HCC 的发生率明显低于无 SVR 组（5.1/1000 人年比 15.0/1000 人年）。获得 SVR 与 HCC 风险显著降低相关（调整后的危险比：0.32；95%CI 0.16-0.67）。肝硬化与 HCC 和肝功能失代偿的发生风险增加相关。这些发现强调了早期 DAA 治疗的重要性，特别是对肝硬化患者。
