Impact Of Direct Acting Antiviral Agents On Liver Function In Patients With Chronic Hepatitis C Virus Infection.

Johnson, Philip J, Berhane, Sarah, Walker, Alex J, Gordon, Fiona H, Ryder, Steven D, McPherson, Stuart, Sreedharan, Aravamuthan, Ustianowski, Andrew A, Agarwal, Kosh, Mutimer, David, Kumada, Takeshi, Toyoda, Hidenori and Irving, William L (2020) Impact Of Direct Acting Antiviral Agents On Liver Function In Patients With Chronic Hepatitis C Virus Infection. Journal of viral hepatitis. ISSN 1365-2893. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: http://onlinelibrary.wiley.com/journal/10.1111/(IS...

Abstract

Whilst the benefit of Direct Acting Antiviral Agents (DAAs) in achieving sustained virological response (SVR) is now well-accepted their impact on liver function, particularly in relation to achievement of SVR, has not been well documented. We studied 2394 patients with chronic HCV infection, 1276 receiving DAAs and 1118 interferon-based therapy. Liver function was assessed by the ALBI score or grade. Overall survival according to SVR status and baseline ALBI grade was examined. We also studied time to first decompensation according to ALBI grade, as well as longitudinal changes in ALBI score over time according to SVR.Among the patients receiving DAAs, 89% achieved SVR (Japan=99%, UK=78%). Amongst the decompensated patients in the UK cohort, three distinct risk groups according to ALBI grade at baseline were observed. The UK patients receiving DAAs, who had predominantly decompensated disease, showed clear evidence of improvement of liver function detectable within two years of the start of treatment, especially in those achieving SVR. These early changes in liver function were very similar to those observed in the first 2-3 years after interferon-based therapy. DAAs improve liver function especially in those with decompensated disease who achieve SVR. Experience with interferon-based therapy suggests that failure to achieve SVR is associated with long-term decline in liver function and, in contrast, patients who do achieve SVR can expect long-term disease improvement and subsequent stabilisation of liver function. Our initial analysis suggests that those receiving DAAs are likely, in the long term, to follow a similar course.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QZ Pathology. Oncology
WA Patients. Primary care. Medical profession. Forensic medicine
WI Digestive system. Gastroenterology
WY Nursing
Divisions: Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 05 Oct 2020 10:58
Last Modified: 05 Oct 2020 10:58
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3507

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