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Chronic Hepatitis C: Impact of Direct-Acting Antiviral Therapy

Insured patients with chronic hepatitis C (CHC) had better hepatic and nonhepatic outcomes and improved long-term survival after treatment with direct-acting antiviral agents (DAAs), a retrospective cohort study shows.

Among 245,596 adult patients with CHC in the Optum Clinformatics Data Mart database for 2010 to 2021, 40,654 patients received 1 or more prescriptions for DAA medication (without interferon). The researchers used the incidence of hepatocellular carcinoma (HCC), liver decompensation, relevant nonliver events (nonliver cancer, diabetes, chronic kidney disease, cardiovascular disease), and overall mortality to examine the treatment effects of a DAA.

Patients treated with DAAs had improved less hepatic decompensation, HCC in compensated cirrhosis, diabetes, and chronic kidney disease. “The all-cause mortality rates per 1000 person-years were also significantly lower in DAA-treated compared with untreated patients (mortality, 36.5 [95% CI, 35.4-37.7] vs 64.7 [95% CI, 63.9-65.4]; P < .001),” the researchers report. “In multivariable regression analysis, DAA treatment was independently associated with a significant decrease in the risk of liver (adjusted hazard ratio [aHR] for HCC, 0.73; decompensation, 0.36), nonliver (aHR for diabetes, 0.74; chronic kidney disease, 0.81; cardiovascular disease, 0.90; nonliver cancer, 0.89), and mortality outcomes (aHR, 0.43).”

Source: JAMA Internal Medicine