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- Title
Non‐liver‐related mortality in the DAA era: Insights from post‐SVR patients with and without previous HCC history.
- Authors
Miuma, Satoshi; Miyaaki, Hisamitsu; Ichikawa, Tatsuki; Matsuzaki, Toshihisa; Goto, Takashi; Kamo, Yasuhiro; Shigeno, Masaya; Hino, Naoyuki; Ario, Keisuke; Yanagi, Kenji; Tsutsumi, Takuya; Fukushima, Nobuyoshi; Nakashiki, Suguru; Yamasaki, Kazufumi; Hamasaki, Keisuke; Shibata, Hidetaka; Arima, Kazuhiko; Yamamichi, Shinobu; Yamashima, Mio; Takahashi, Kosuke
- Abstract
Background and Aims: Mortality after sustained virological response (SVR) with interferon‐free direct‐acting antiviral (IFN‐free DAA) therapy is crucial for optimizing post‐SVR patient care, but it remains unclear, especially regarding non‐liver‐related mortality. Methods: Consecutive post‐SVR patients from 14 institutions were stratified into three cohorts: A (without advanced fibrosis and without prior HCC), B (with advanced fibrosis and without prior HCC), and C (curative HCC treatment). We assessed mortality (per 1000 person‐years [/1000PY]) post‐SVR. Mortality rates were compared between cohorts A and B and the general population using age‐ and sex‐adjusted standardized mortality ratio (SMR). Comparison of survival between each cohort was performed using propensity‐score (PS) matching with sex, age, and comorbidity. Results: In cohort A (n = 762; median age, 65 years), 22 patients died (median follow‐up, 36 months); all‐cause mortality was 10.0/1000PY, with 86.4% non‐liver‐related deaths. In cohort B (n = 519; median age, 73 years), 27 patients died (median follow‐up, 39 months); all‐cause mortality was 16.7/1000PY, with 88.9% non‐liver‐related deaths. In both cohorts, malignant neoplasm was the most common cause of death; all‐cause mortality was comparable to that of the general population (SMR: 0.96 and 0.92). In cohort C (n = 108; median age, 75 years), 15 patients died (median follow‐up, 51 months); all‐cause mortality was 36.0/1000PY, with 53.3% liver‐related deaths. PS matching showed no significant survival differences between cohorts A and B, both of which had better survival than cohort C. Conclusions: Mortality varies based on HCC history in the DAA era; nevertheless, attention should be paid to non‐liver‐related deaths in all post‐SVR patients.
- Subjects
DEATH rate; MORTALITY; CAUSES of death; PATIENT care
- Publication
Journal of Medical Virology, 2024, Vol 96, Issue 3, p1
- ISSN
0146-6615
- Publication type
Article
- DOI
10.1002/jmv.29432