For the first time, researchers have observed powerful evidence that treating hepatitis C virus (HCV) with direct-acting antiviral (DAAs) is associated with a reduced risk of liver cancer and death.
French investigators observed a cohort of nearly 10,000 people living with HCV, about three quarters of whom were treated with DAAs during follow-up. The study excluded those with a history of decompensated cirrhosis, the advanced form of the severe liver disease.
About 3,000 of the participants had cirrhosis while 6,850 did not have cirrhosis or had unclassified fibrosis (liver scarring); cirrhosis is the most severe stage of fibrosis.
Those who received treatment began DAAs a median of four months after their entry into the cohort and were followed for a median of 33 months after starting the medications. The untreated cohort members were followed for a median of 31 months.
The study authors adjusted the data to account for differences between cohort members according to a host of variables that might have influenced their health outcomes.
Compared with those not receiving the medications, receiving DAAs was associated with a 52% lower risk of death from any cause, including a 41% reduced risk of liver-related death and a 34% reduction in the risk of liver cancer.
“There is mounting and persuasive evidence for the long-term clinical benefit of HCV cure, both with regard to liver and overall health outcomes,” Raymond T. Chung, MD, a liver specialist at Massachusetts General Hospital in Boston, wrote in a commentary that accompanied the study’s publication. “In light of these benefits, there is now little excuse for failing to identify all infected persons and to treat and cure each of them once identified.”