Hepatitis C virus eradication decreases the risks of liver cirrhosis and cirrhosis-related complications (Taiwanese chronic hepatitis C cohort).
BACKGROUND AND AIM
It is currently unknown how hepatitis C virus (HCV) eradication with pegylated interferon and ribavirin (PR) therapy affects the incidence of new-onset liver cirrhosis (LC) in patients without cirrhosis and the incidence of decompensated liver disease (DLD) or hepatocellular carcinoma (HCC) in patients with cirrhosis.


METHODS
Taiwanese chronic hepatitis C cohort (T-COACH) is a nationwide HCV registry cohort from 23 hospitals in Taiwan recruited between 2003 and 2015. This study enrolled 10 693 patients with chronic hepatitis C (CHC), linked to the Taiwan National Health Insurance Research Database, receiving PR therapy for at least 4 weeks for new-onset LC and liver-related complications (DLD or HCC).


RESULTS
Of the 10 693 patients, 1372 (12.8%) patients had LC, and the mean age was 54.0 ± 11.4 years. The mean follow-up duration was 4.38 ± 2.79 years, with overall 46 798 person-years. The 10-year cumulative incidence rates of new-onset LC were 5.0% (95% confidence interval [CI]: 3.2-7.7) in patients without cirrhosis with a sustained virologic response (SVR) and 21.9% (95% CI: 13.4-32.4) in those without SVR (hazard ratio [HR]: 0.22, P < 0.001). The 10-year cumulative incidence rates of liver-related complications were 21.4% (95% CI: 11.1-37.2) in patients with cirrhosis with SVR and 47.0% (95% CI: 11.1-86.0) in those without SVR after adjustment for age, sex, and competing mortality (HR: 0.52, P < 0.001).


CONCLUSIONS
Hepatitis C virus eradication with PR therapy decreased the incidence of new-onset LC in noncirrhotic patients and the incidence of liver-related complications in cirrhotic patients with CHC.
['Hsu|Wei-Fan|WF|https://orcid.org/0000-0002-0738-417X', 'Tsai|Pei-Chein|PC|', 'Chen|Chi-Yi|CY|', 'Tseng|Kuo-Chih|KC|https://orcid.org/0000-0002-4811-3018', 'Lai|Hsueh-Chou|HC|', 'Kuo|Hsing-Tao|HT|', 'Hung|Chao-Hung|CH|https://orcid.org/0000-0003-1646-9519', 'Tung|Shui-Yi|SY|', 'Wang|Jing-Houng|JH|', 'Chen|Jyh-Jou|JJ|', 'Lee|Pei-Lun|PL|', 'Chien|Ron-Nan|RN|', 'Lin|Chun-Yen|CY|', 'Yang|Chi-Chieh|CC|', 'Lo|Gin-Ho|GH|', 'Tai|Chi-Ming|CM|', 'Lin|Chih-Wen|CW|https://orcid.org/0000-0003-2344-5056', 'Kao|Jia-Horng|JH|https://orcid.org/0000-0002-2442-7952', 'Liu|Chun-Jen|CJ|https://orcid.org/0000-0002-6202-0993', 'Liu|Chen-Hua|CH|', 'Yan|Sheng-Lei|SL|', 'Bair|Ming-Jong|MJ|', 'Su|Wei-Wen|WW|', 'Chu|Cheng-Hsin|CH|', 'Chen|Chih-Jen|CJ|', 'Lo|Ching-Chu|CC|', 'Cheng|Pin-Nan|PN|https://orcid.org/0000-0001-9331-9018', 'Chiu|Yen-Cheng|YC|', 'Wang|Chia-Chi|CC|https://orcid.org/0000-0002-0827-4503', 'Cheng|Jin-Shiung|JS|', 'Tsai|Wei-Lun|WL|', 'Lin|Han-Chieh|HC|', 'Huang|Yi-Hsiang|YH|https://orcid.org/0000-0001-5241-5425', 'Huang|Jee-Fu|JF|', 'Dai|Chia-Yen|CY|https://orcid.org/0000-0003-2296-3054', 'Chuang|Wan-Long|WL|', 'Yu|Ming-Lung|ML|https://orcid.org/0000-0001-8145-1900', 'Peng|Cheng-Yuan|CY|https://orcid.org/0000-0001-9030-6086']
liver cirrhosis chronic hepatitis C decompensated liver disease hepatocellular carcinoma T-COACH