Byambasuren Amgalan, Gyarvuulkhasuren Buyankhishig, Erdenebat Byambatsogt, Nyamdavaa Khurelbaatar, Baatarkhuu Oidov
Department of Health Research, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
General Hospital of the Arkhangai Province, Tsetserleg 65191, Mongolia.
Viruses. 2025 May 22;17(6):743. doi: 10.3390/v17060743.
(1) Background: Hepatitis C virus (HCV) infection poses a significant health burden, particularly in Mongolia, where the HCV prevalence is notably high. This study evaluates the long-term outcomes of HCV treatment with ledipasvir/sofosbuvir, focusing on mortality, viral relapse, and hepatocellular carcinoma (HCC) development. (2) Methods: This prospective, longitudinal cohort study initially enrolled patients with chronic HCV in Mongolia between 2016 and 2017, focusing on those who completed the five-year follow-up ( = 303). The study measured long-term mortality, HCC development, and viral relapse, employing non-invasive methods to assess liver fibrosis and liver function. (3) Results: At the outset, 98.2% of the patients achieved undetectable HCV RNA levels. Over five years, 6.27% experienced viral relapse and 3.30% developed hepatocellular carcinoma (HCC), with a mortality rate of 5.94%. In a multivariable analysis, the significant predictors for HCC occurrence included age (OR = 1.081, 95% CI = 1.021-1.145), liver cirrhosis (OR = 5.866, 95% CI = 1.672-22.577), and GGT level (OR = 1.011, 95% CI = 1.004-1.018). The independent predictors of mortality included age (OR = 1.083, 95% CI = 1.024-1.147), liver cirrhosis (OR = 6.529, 95% CI = 1.913-22.281), and GGT (OR = 1.011, 95% CI = 1.004-1.017). (4) Conclusions: This study demonstrates that ledipasvir/sofosbuvir effectively suppresses HCV initially and maintains low viral relapse rates over the long term. However, it emphasizes the need for continued management to reduce the long-term risk of HCC and mortality, especially in patients with severe liver fibrosis or cirrhosis.
（1）背景：丙型肝炎病毒（HCV）感染造成了重大的健康负担，在蒙古尤其如此，该国的HCV患病率显著较高。本研究评估了使用来迪派韦/索磷布韦治疗HCV的长期疗效，重点关注死亡率、病毒复发和肝细胞癌（HCC）的发生情况。（2）方法：这项前瞻性纵向队列研究最初于2016年至2017年在蒙古招募慢性HCV患者，重点关注那些完成了五年随访的患者（n = 303）。该研究测量了长期死亡率、HCC的发生情况和病毒复发情况，采用非侵入性方法评估肝纤维化和肝功能。（3）结果：一开始，98.2%的患者HCV RNA水平检测不到。在五年期间，6.27%的患者出现病毒复发，3.30%的患者发生肝细胞癌（HCC），死亡率为5.94%。在多变量分析中，HCC发生的显著预测因素包括年龄（OR = 1.081，95% CI = 1.021 - 1.145）、肝硬化（OR = 5.866，95% CI = 1.672 - 22.577）和γ-谷氨酰转移酶（GGT）水平（OR = 1.011，95% CI = 1.004 - 1.018）。死亡率的独立预测因素包括年龄（OR = 1.083，95% CI = 1.024 - 1.147）、肝硬化（OR = 6.529，95% CI = 1.913 - 22.281）和GGT（OR = 1.011，95% CI = 1.004 - 1.017）。（4）结论：本研究表明，来迪派韦/索磷布韦最初能有效抑制HCV，并在长期内维持较低的病毒复发率。然而，该研究强调需要持续管理以降低HCC和死亡率的长期风险，特别是在患有严重肝纤维化或肝硬化的患者中。
