Direct-acting antivirals showed a clinical effect on chronic hepatitis C patients, according to a large cohort study published in the Lancet, a medical journal.
The study results revealed that chronic hepatitis C patients who were treated with the direct-acting antivirals were 52 percent less likely to die prematurely than those who were not treated, and 34 percent less likely to develop hepatocellular carcinoma than the other group.
On Monday, the Lancet unveiled the French researchers’ large cohort study, which compared risks of mortality, hepatocellular carcinoma, and decompensated cirrhosis in patients treated with the direct-acting antivirals and those untreated.
The researchers conducted a prospective study on adult patients with chronic hepatitis C infection in 32 centers in France. The research excluded hepatitis B patients, those with decompensated cirrhosis history, liver cancer patients, liver transplant patients, and those who were treated with interferon-ribavirin or first-generation protease inhibitors.
The researchers used observational data of 9,895 out of 10,166 patients from Aug. 6, 2012, to Dec. 31, 2015. The median observation period was 33.4 months. During the follow-up, 7,344 were treated with direct-acting antivirals, and 2,551 untreated.
During the follow-up, 218 patients died (129 treated, 89 untreated), 258 reported hepatocellular carcinoma (187 treated, 71 untreated), and 106 had decompensated cirrhosis (74 treated, 32 untreated).
The researchers concluded that direct-acting antiviral treatment was associated with reduced risk of mortality and hepatocellular cancer and physicians should consider the treatment in all patients with chronic hepatitis C infection.
Medical professionals have been split over whether direct-acting antiviral treatment raises the chance of hepatocellular cancer in the treatment of chronic hepatitis C. Studies have steadily reported that conventional interferon treatment lowered the risk of liver cancer.
However, the debate was rekindled in 2016 when a Spanish study said using direct-acting antivirals could raise the risk of recurrence and development of hepatocellular cancer.
Park Jun-yong, a professor at Liver Center of Severance Hospital, said the latest study published in the Lancet was the first prospective research that proved direct-acting antiviral treatment lowered the risk of liver cancer.
He also emphasized the significance of the early treatment of chronic hepatitis C.
“Although the study focused on mortality and liver cancer, hepatitis C is not only about a liver disease but a systemic disease associated with other illnesses such as dementia and diabetes,” Park said. “If we discover hepatitis C early, we can prevent other diseases, too.”
With the Lancet study, local liver specialists’ claim -- that direct-acting antiviral treatment of chronic hepatitis C can reduce socio-economic costs – will gain support.
Park noted that among infectious diseases that cause chronic illnesses, a curable one was rare. “Because hepatitis C is curable if found early, we can lower the risk of liver cancer which is costly to treat,” he said.
Park suggested the government-supported health checkup include the hepatitis C antibody test for a particular age group and carry out once or twice screenings regularly. Doing so could help physicians diagnose hepatitis C patients and provide care early, and reduce socio-economic cost burden caused by cirrhosis or liver cancer, he added.