Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population.

Background & Aims: Life expectancy of patients with compensated hepatitis C virus (HCV) cirrhosis achieving sustained virologic response (SVR) is limited by liver events as compared tothe general population. Thus, survival benefit of SVR remains tobe measured.Methods: The study includes prospective surveillance data fromthree cohorts of Italian patients with compensated HCV cirrhosiswho achieved SVR on an interferon-based (IFN) regimen, compared to simultaneously observed non-SVR, untreated anddecompensated patients. Overall survival was calculated fromthe date of start of IFN to death. The number of deaths expectedduring the at-risk period was determined by applying age- andsex-specific mortality rates recorded in Italy for person-yearsadequate for the enrolment period. The standardized mortalityratio (SMR) determined the relative risk of death over that ofthe age and sex matched general population.Results: Overall, 28/181 patients followed-up for a medianperiod of 9.6 years (range 1–25 years) died. The 10 and 20-yearoverall survival rates for the whole series were 90.9% (95% CI,84.3–94.8) and 62.9% (95% CI, 45.9–75.9), respectively. The number of expected deaths in the corresponding age and sex matchedgeneral population was 28.1, corresponding to a SMR = 1.00 (95%CI, 0.72–1.35), with an SMR for non-SVR patients of 3.85 (95% CI,3.43–4.30), for untreated of 3.01 (95% CI, 2.64–3.42) and fordecompensated of 6.70 (95% CI, 5.39–8.22).Conclusions: Patients with compensated HCV cirrhosis achievingSVR by IFN obtain a main benefit levelling their survival curve tothat of the general population. Wider applicability of IFN-free regimens will possibly make this achievement more generalizable.