Viral eradication reduces all‐cause mortality in patients with chronic hepatitis C virus infection who had received direct‐acting antiviral therapy

Abstract

AbstractBackground and AimsThe impact of hepatitis C virus (HCV) eradication via direct‐acting antiviral (DAA) therapy on overall mortality, particularly non‐liver‐related mortality, is understudied.MethodsWe recruited 4180 patients with chronic HCV infection who achieved sustained virological response (SVR) (HCV eradication) through DAA therapy (n = 2501, SVR group) or who did not receive antiviral therapy (n = 1679, non‐SVR group); 1236 from each group were chosen using propensity score matching. Causes of death and all‐cause mortality, including non‐liver‐related diseases, were investigated.ResultsOf the 4180 patients, 592 died during the follow‐up period. In the SVR group, the mortality rates from liver‐related and non‐liver‐related diseases were 16.5% and 83.5%, respectively. Compared to the non‐SVR group, mortality rates from liver‐related and non‐liver‐related diseases were 50.1% and 49.9%, respectively (p < .001). In non‐cirrhotic patients, multivariable analysis revealed that SVR was an independent factor associated with both liver‐related (hazard ratio [HR], .251; 95% confidence interval [CI], .092–.686) and non‐liver‐related (HR, .641; 95% CI, .415–.990) mortalities. In cirrhotic patients, multivariable analysis revealed that SVR remained an independent factor significantly associated with liver‐related mortality (HR, .151; 95% CI, .081–.279). In propensity score‐matched patients, the eradication of HCV (SVR group) decreased both liver‐related (p < .001) and non‐liver‐related mortality (p = .008) rates compared to persistent HCV infection (non‐SVR group).ConclusionsThe elimination of HCV via DAA therapy reduced not only liver‐related mortality but also non‐liver‐related mortality in patients with chronic HCV.