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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; Kudama, Takeshi; Toyoda, Hidenori; Irving, William L; HCV Research UK

Authors

Philip J. Johnson philip.johnson@liverpool.ac.uk

Sarah Berhane

Alex J. Walker

Fiona H. Gordon

Steven D. Ryder

Stuart McPherson

Aravamuthan Sreedharan

Andrew A. Ustianowski

Kosh Agarwal

David Mutimer

Takeshi Kudama

Hidenori Toyoda

HCV Research UK



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.

Journal Article Type Article
Publication Date Sep 26, 2020
Journal Journal of Viral Hepatitis
Print ISSN 1352-0504
Electronic ISSN 1365-2893
Publisher Wiley
Peer Reviewed Peer Reviewed
APA6 Citation HCV Research UK, , Johnson, P. J., Berhane, S., Walker, A. J., Gordon, F. H., Ryder, S. D., …Irving, W. L. (2020). Impact Of Direct Acting Antiviral Agents On Liver Function In Patients With Chronic Hepatitis C Virus Infection. Journal of Viral Hepatitis, https://doi.org/10.1111/jvh.13408
DOI https://doi.org/10.1111/jvh.13408
Keywords Hepatitis C Virus; ALBI score; Sustained Virological Response; Direct Acting Antivirals; Interferon therapy; liver function
Additional Information Authors and HCV Research UK
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