A cohort study on the progression of liver disease in patients with chronic hepatitis C after antiviral treatment
10.3760/cma.j.cn311365-20250315-00081
- VernacularTitle:慢性丙型肝炎患者抗病毒治疗后肝脏疾病进展情况的队列研究
- Author:
Boping DENG
1
;
Muqing WU
;
Weiwei MENG
;
Jingyu CUI
;
Zhiyuan WEI
;
Yi GAO
;
Tao WU
Author Information
1. 海南医科大学附属海南医院/海南省人民医院感染科，海口 570311
- Publication Type:Journal Article
- Keywords:
Hepatitis C, chronic;
Sustained virological response;
Liver-related events;
Event-free survival;
Direct-acting antiviral drugs;
Interferon
- From:
Chinese Journal of Infectious Diseases
2025;43(4):193-201
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the sustained virological response (SVR) and viral recurrence in patients with chronic hepatitis C (CHC) after antiviral treatment, and to further analyze the influencing factors of liver-related events (LRE).Methods:This was a retrospective cohort study. A total of 1 844 CHC patients who visited the Department of Infectious Diseases of Hainan General Hospital from January 1st, 2013 to December 31st, 2022 were included. After screening, 891 patients were selected and divided into direct-acting antiviral agent (DAA) treatment group, interferon treatment group and non-antiviral treatment group based on different intervention measures. Propensity score matching was performed, and SVR and viral recurrence were compared among the three groups. Statistical analysis was performed using the chi-square test, and multivariate Cox regression analysis was used to evaluate the risk factors for LRE.Results:The confirmed CHC patients showed an increasing trend year by year (average annual change percentage=19.97%, 95% confidence interval ( CI) 10.46% to 30.30%, t=4.32, P<0.001). After propensity score matching, the total sample size of 891 CHC patients was 451, including 100 in the interferon treatment group, 311 in the DAA treatment group, and 40 in the non-antiviral treatment group. In the interferon treatment group, 89 cases (89.00%) achieved SVR and nine cases (9.00%) had recurrence. In the DAA treatment group, 306 cases (98.39%) achieved SVR and 10 cases (3.22%) had recurrence. The differences were statistically significant ( χ2=17.84 and 6.22, respectively, both P<0.05). Cox multivariate regression analysis showed that age (hazard ratio ( HR)=1.065, 95% CI 1.028 to 1.104, P<0.001), alcohol consumption ( HR=3.034, 95% CI 1.302 to 7.071, P=0.010) were independent risk factors for LRE in CHC patients, while albumin ( HR=0.858, 95% CI 0.802 to 0.917, P<0.001), DAA treatment ( HR=0.267, 95% CI 0.103 to 0.692, P=0.007) were protective factors. In CHC patients receiving antiviral treatment, diabetes ( HR=6.719, 95% CI 2.242 to 20.137, P<0.001), total bilirubin ( HR=1.111, 95% CI 1.054 to 1.171, P<0.001) and viral recurrence ( HR=4.646, 95% CI 1.322 to 16.321, P=0.017) were independent risk factors for LRE. Conclusions:Compared with interferon treatment, DAA treatment has a significantly higher SVR rate and a lower recurrence rate. Age and alcohol consumption are independent risk factors for LRE, while higher albumin levels and DAA treatment are protective factors. In CHC patients receiving antiviral treatment, diabetes, viral recurrence, and total bilirubin are independent risk factors for LRE.
