So back in late 2017 the Cochrane Collaboration made the bold claim that treatment with Direct Acting Antivirals did not have any measurable impact on clinical outcomes. While the medical profession as a whole expressed a large and collective WTF sentiment new research published in the Lancet – “Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study” – puts this question to bed. The full text of the article and the editorial comment are attached, but here is the summary:
Findings of adjusted multivariable analyses showed that exposure to direct-acting antivirals significantly reduced all-cause mortality (hazard ratio [HR] 0·48, 95% CI 0·33–0·70; p=0·0001), liver-related mortality (0·39, 0·21–0·71; p=0·0020), non-liver-related mortality (0·60, 0·36–1·00; p=0·048), and hepatocellular carcinoma (0·66, 0·46–0·93; p=0·018), but not decompensated cirrhosis (1·14, 0·57–2·27; p=0·72). These associations persisted when the analysis was restricted to patients with cirrhosis who achieved sustained virological response. By contrast, failure to achieve sustained virological response was associated with increased risk for hepatocellular carcinoma (HR 2·23, 95% CI 1·37–3·64; p=0·0012).
Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study
Lancet editorial commentary
