Effect of sustained virological response on long-term clinical outcome in 113 patients with compensated hepatitis C-related cirrhosis treated by interferon alpha and ribavirin

AIM:To assess the long-term clinical benefit of sustained virological response(SVR)in patients with hepatitis C virus(HCV)cirrhosis treated by antiviral therapy using mostly ribavirin plus interferon either standard or pegylated.METHODS:One hundred and thirteen patients with uncomplicated HCV biopsy-proven cirrhosis,treated by at least one course of antiviral treatment ≥ 3 mo and followed ≥ 30 mo were included.The occurrence of clinical events hepatocellular carcinoma(HCC),decompensation and death was compared in SVR and non SVR patients.RESULTS:Seventy eight patients received bitherapy and 63 had repeat treatments.SVR was achieved in 37 patients(33%).During a mean follow-up of 7.7 years,clinical events occurred more frequently in non SVR than in SVR patients,with a significant difference for HCC(24/76 vs 1/37,P = 0.01).No SVR patient died while 20/76 non-SVR did(P = 0.002),mainly in relation to HCC(45%).CONCLUSION:In patients with HCV-related cirrhosis,SVR is associated with a significant decrease in the incidence of HCC and mortality during a follow-up period of 7.7 years.This result is a strong argument to perform and repeat antiviral treatments in patients with compensated cirrhosis.