Hallager S, et al. - This article was written with the objective to estimate liver-related morbidity and mortality among patients with chronic hepatitis C (CHC) and cirrhosis in Denmark with and without antiviral treatment and sustained virologic response (SVR). Furthermore, they also estimate the rate of hepatocellular carcinoma (HCC) and decompensation related to certain prognostic factors. Researchers found that alcohol overuse, hepatitis C genotype 3, and diabetes were related to liver-related morbidity in patients with CHC and cirrhosis. SVR markedly decreased liver-related morbidity and mortality; however, special attention to patients with alcohol overuse must continue after SVR.

Methods

• For this study, patients with CHC and cirrhosis registered in the Danish Database for Hepatitis B and C were qualified.
• Cirrhosis was based on liver biopsy, transient elastography, and clinical cirrhosis.
• Data were extracted from nationwide registries.
• The study period was from 2002 until 2013.

Results

• Total 1,038 patients were included in this study.
• Seven hundred sixty (69%) were male and the median age was 52 years.
• Median follow-up was 3.8 years, 360 patients died, and 233 of 519 treated patients achieved SVR.
• Alcohol overuse and hepatitis C virus genotype 3 were related to an increased incidence rate (IR) of HCC, whereas diabetes and alcohol overuse were related to increased IRs of decompensation.
• Achieving SVR reduced all-cause mortality (adjusted mortality rate ratio 0.68 [95% CI 0.43–1.09]) and liver-related mortality (mortality rate ratio 0.6 [95% CI 0.36–1]), and also liver-related morbidity with adjusted IR ratios of 0.37 (95% CI 0.22–0.62) for HCC and 0.31 (95% CI 0.17–0.57) for decompensation.
• The IRs of HCC and decompensation remained elevated in patients with alcohol overuse after SVR.