HCV: Direct-Acting Antivirals May Reduce Mortality, Liver Cancer Risk

The first prospective, longitudinal study investigating the treatment of chronic hepatitis C virus (HCV) with direct-acting antivirals (DAAs) has found that it may lead to a reduced risk of morality and liver cancer.

Researchers held an observational study with approximately 10,000 patients from 32 centers in France. Three-quarters of patients had been treated with DAAs and the remaining patients were untreated. After approximately 15 months, they were given follow-up information. During follow-up, 218 patients died (129 treated, 89 untreated), 258 reported hepatocellular carcinoma (187 treated, 71 untreated), and 106 had decompensated cirrhosis (74 treated, 32 untreated), according to the press release.

Those who were given more than one course of direct-acting antivirals were considered by researchers to have had continuous exposure, regardless of interim time or whether or not the first course had been associated with virological response. The study excluded patients with a history of decompensated cirrhosis and liver transplantation, who may be at the highest risk for complications.

The study, recently published in The Lancet, was the first to compare those who had been treated with interferon or direct-acting antivirals with those who were not treated. It found that treated patients were 52% less likely to die prematurely and 33% were less likely to have hepatocellular carcinoma within a year than those untreated.

HCV affects approximately 71 million people globally and can lead to conditions such as cirrhosis, liver disease, hepatocellular carcinoma. Amid peak projections set for 2030 and 2035, the World Health Organization have set targets for eliminating hepatitis C, and, subsequently, a reduction of complications. The Lancet study represents a potential to reach these targets by 2030.

"Taking a large cohort like this provides the opportunity to evaluate the effect of direct-acting antiviral therapy on the long-term outcomes of patients with hepatitis C,” study co-author Fabrice Carrat said in a prepared statement. “We saw a reduction of risk for complications related to the disease, and to mortality, and believe this treatment should be considered for all patients with chronic hepatitis C infection."