Long Term Follow Up of Chronic Hepatitis C Patients: Will Sustained Virological Response be Enough to Prevent Cirrhosis in The Long Term?

Abstract

AIMS: In the present study, we aimed to evaluate the impact of sustained virological response (SVR) and some other predictive factors on development of cirrhosis secondary to chronic hepatitis C (CHC).

MATERIALS AND METHODS: 100 patients with CHC, who were followed at least 1 year between 2000-2015 in Uludag University, School of Medicine Hospital were reviewed and cirrhosis development was investigated.

RESULTS: The median follow-up period was 5.9 (1-14.4) years. The 10 year cumulative incidence of cirrhosis was significantly lower in the treated group compared to untreated group (19.5% and 44.4%, p = 0.025). In treated group; cirrhosis wasn’t observed in the cases with SVR (p < 0.001). Univariate analysis revealed that female gender (p = 0.041), age ≤ 40 (p = 0.05), platelet count > 150.000 (p < 0.001), low AST/ALT score (p = 0.003), low Fibrosis-4 score (p < 0.001), low AST/Platelet ratio index score (p < 0.001), SVR (p < 0.001) resulted in statistically significant less cirrhosis. In cox regression analysis; SVR was found to be the only independent factor affecting development of cirrhosis (Hazard ratio, HR = 0.279; p = 0.04).

CONCLUSION: Although there are useful parameters in predicting the development of cirrhosis in CHC patients, SVR is the only independent factor to prevent cirrhosis. Elimination of cirrhosis with higher SVR rates with currently used new direct-acting antiviral agents will be probably shown in the future long term studies.