People who are cured of hepatitis C virus (HCV) when they have minimal or no liver fibrosis (scarring) have a very low rate of liver-health problems during the subsequent three years.
Researchers analyzed data from the Gilead SVR Registry, which includes individuals who entered the registry within three months of being cured of hep C with a regimen including at least one of the direct-acting antiviral medications manufactured by Gilead Sciences. These include Sovaldi (sofosbuvir), Harvoni (ledipasvir/sofosbuvir), Epclusa (sofosbuvir/velpatasvir) and Vosevi (sofosbuvir/velpatasvir/voxilaprevir). The registry members received follow-up testing of liver-health measures every 24 weeks after their cure for up to 144 weeks.
Presenting their findings at the Annual Meeting of the American Association for the Study of Liver Diseases (AASLD) in Washington, DC, researchers analyzed data on 1,444 people with F0 (no) or F1 (minimal) liver fibrosis according to the Metavir scoring system. A total of 580 of them completed the full 144 weeks of follow-up, 545 are still enrolled in follow-up and 319 dropped out of follow-up before 144 weeks were up.
Only three people experienced a notable liver-related health event during follow-up, including one who experienced jaundice at week 48, one who had ascites at week 72 and one who developed hepatic encephalopathy at week 120. The number of people who contributed data to each of these respective follow-up points was 1,013, 913 and 660, making the proportion who experienced a liver-related health event at each point a respective 0.1 percent, 0.1 percent and 0.2 percent.
Six people from the cohort died, none of them of liver-related causes. No one developed hepatocellular carcinoma (HCC, the most common form of liver cancer).
Eight people tested positive for hep C during follow-up, indicating that, up to 192 weeks after finishing treatment, 98.9 percent maintained their sustained virologic response (which is akin to a cure). Genetic analysis revealed that all but one of these individuals were reinfected with a new strain of the virus. The one person whose virus rebounded, at 141 weeks after finishing treatment, was a 41-year-old white woman treated with Sovaldi plus ribavirin for 12 weeks. She did not have cirrhosis and had not been treated for hep C before.
To read the conference abstract, click here.
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