Disease Progression in Patients With Hepatitis C Virus Infection Treated With Direct-Acting Antiviral Agents.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mendizabal Manuel, Piñero Federico, Ridruejo Ezequiel, Herz Wolff Fernando, Anders Margarita, Reggiardo Virginia, Ameigeiras Beatriz, Palazzo Ana, Alonso Cristina, Schinoni María Isabel, Videla Zuain María Grazia, Tanno Federico, Figueroa Sebastián, Santos Luisa, Peralta Mirta, Soza Alejandro, Vistarini Cecilia, Adrover Raúl, Fernández Nora, Perez Daniela, Hernández Nelia, Estepo Claudio, Bruno Andres, Descalzi Valeria, Sixto Marcela, Borzi Silvia, Cocozzella Daniel, Zerega Alina, de Araujo Alexandre, Varón Adriana, Rubinstein Fernando, Cheinquer Hugo, Silva Marcelo, Latin American Liver Research, Educational and Awareness Network (LALREAN)
Аннотация
METHODS: We performed a prospective multicenter cohort study of 1760 patients who received DAA treatment at 23 hospitals in Latin America, from May 1, 2016, through November 21, 2019. We excluded patients with a history of liver decompensation, hepatocellular carcinoma (HCC), or solid-organ transplantation. Disease progression after initiation of DAA therapy included any of the following new events: liver decompensation, HCC, liver transplantation, or death. Evaluation of variables associated with the primary outcome was conducted using a time-dependent Cox proportional hazards models.
RESULTS: During a median follow-up period of 26.2 months (interquartile range, 15.3-37.5 mo), the overall cumulative incidence of disease progression was 4.1% (95% CI, 3.2%-5.1%), and after SVR assessment was 3.6% (95% CI, 2.7%-4.7%). Baseline variables associated with disease progression were advanced liver fibrosis (hazard ratio [HR], 3.4; 95% CI, 1.2-9.6), clinically significant portal hypertension (HR, 2.1; 95% CI, 1.2-3.8), and level of albumin less than 3.5 mg/dL (HR, 4.1; 95% CI, 2.3-7.6), adjusted for SVR achievement as a time covariable. Attaining an SVR reduced the risk of liver decompensation (HR, 0.3; 95% CI, 0.1-0.8; P = .016) and de novo HCC (HR, 0.2; 95% CI, 0.1%-0.8%; P = .02) in the overall cohort.
CONCLUSIONS: Treatment of hepatitis C virus infection with DAAs significantly reduces the risk of new liver-related complications and should be offered to all patients, regardless of disease stage. Clinicaltrials.gov: NCT03775798.