Impact of distinct antiviral treatment regimens on the long-term outcome after HCV cure - Data from the German Hepatitis C-Registry (DHC-R).

IF 1.4 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
Zeitschrift fur Gastroenterologie Pub Date : 2025-05-01 Epub Date: 2025-05-13 DOI:10.1055/a-2543-5205
Valerie Ohlendorf, Yvonne Serfert, Peter Buggisch, Stefan Mauss, Hartwig Klinker, Gerlinde Teuber, Markus Cornberg, Krzysztof Tomasiewicz, Heiner Wedemeyer
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引用次数: 0

Abstract

Direct-acting antiviral (DAA) regimens for the treatment of hepatitis C virus (HCV) infection are endowed with sustained virological response (SVR) rates >95%. However, HCV cure does not completely eliminate the risk of hepatocellular carcinoma (HCC) development and liver decompensation. The present study investigated the impact of the administered DAA regimen on clinical long-time outcomes after SVR.Matched-pair survival analyses of 5802 chronically HCV infected patients from the German Hepatitis C-Registry compared the incidence of liver-related events 2.5 years after SVR in patients receiving either sofosbuvir (SOF)-based treatment or NS3/NS4A-protease inhibitor (PI)-containing DAA regimens. Hypothesis driven logistic regression analyses were performed to identify independent predictors for the occurrence of liver-related events.Matched-pair survival analyses revealed a borderline significant difference in the incidence of liver-related endpoints (except of HCC development) in patients receiving SOF-based treatment (4.1%) compared to PI-containing DAA regimens (2.6%) 2.5 years after SVR (p=0.061). Numerically, a trend towards a benefit of PI-based DAA treatment was observed (PI 65 events vs SOF 102 events). Hypothesis driven logistic regression analyses could not confirm SOF-based treatment as an independent predictor for the occurrence of liver-related events after HCV cure (p=0.072, OR=0.670).The incidence of liver-related events 2.5 years after HCV cure did not differ significantly between SOF-based DAA treatment and PI-containing regimens. However, numerically a trend towards a benefit of PI-based DAA treatment was observed. Therefore, a minor effect of the applied DAA regimen on the long-term incidence of liver-related events cannot be excluded.

不同抗病毒治疗方案对丙型肝炎治愈后长期预后的影响——来自德国丙型肝炎登记处(DHC-R)的数据
用于治疗丙型肝炎病毒(HCV)感染的直接作用抗病毒(DAA)方案具有持续病毒学应答(SVR)率高达95%。然而,HCV治愈并不能完全消除肝细胞癌(HCC)发展和肝脏失代偿的风险。本研究调查了给予DAA方案对SVR后临床长期结局的影响。来自德国丙型肝炎登记处的5802名慢性HCV感染患者的配对生存分析比较了接受索非布韦(SOF)治疗或含有NS3/ ns4a蛋白酶抑制剂(PI)的DAA方案的患者在SVR后2.5年肝脏相关事件的发生率。采用假设驱动的逻辑回归分析来确定肝脏相关事件发生的独立预测因子。配对生存分析显示,在SVR后2.5年,接受基于sofd治疗的患者的肝脏相关终点(HCC发展除外)的发生率(4.1%)与含pi的DAA方案(2.6%)相比存在临界显著差异(p=0.061)。数值上,观察到基于PI的DAA治疗有获益的趋势(PI 65事件vs sof102事件)。假设驱动的logistic回归分析不能证实基于soff的治疗是HCV治愈后肝脏相关事件发生的独立预测因子(p=0.072, OR=0.670)。HCV治愈2.5年后肝脏相关事件的发生率在基于sofa的DAA治疗和含有pi的治疗方案之间没有显著差异。然而,在数值上观察到以pi为基础的DAA治疗有获益的趋势。因此,不能排除应用DAA方案对肝脏相关事件的长期发生率有轻微影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Zeitschrift fur Gastroenterologie
Zeitschrift fur Gastroenterologie 医学-胃肠肝病学
CiteScore
1.40
自引率
15.40%
发文量
562
审稿时长
6-12 weeks
期刊介绍: Die Zeitschrift für Gastroenterologie ist seit über 50 Jahren die führende deutsche Fachzeitschrift auf dem Gebiet der Gastroenterologie. Sie richtet sich an Gastroenterologen und alle anderen gastroenterologisch interessierten Ärzte. Als offizielles Organ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten sowie der Österreichischen Gesellschaft für Gastroenterologie und Hepatologie informiert sie zuverlässig und aktuell über die wichtigen Neuerungen und Entwicklungen in der Gastroenterologie.
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