title: Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population.
abstract: Life expectancy of patients with compensated hepatitis C virus (HCV) cirrhosis achieving sustained virologic response (SVR) is limited by liver events as compared to the general population. Thus, survival benefit of SVR remains to be measured.
  
  
  
  The study includes prospective surveillance data from three cohorts of Italian patients with compensated HCV cirrhosis who achieved SVR on an interferon-based (IFN) regimen, compared to simultaneously observed non-SVR, untreated and decompensated patients. Overall survival was calculated from the date of start of IFN to death. The number of deaths expected during the at-risk period was determined by applying age- and sex-specific mortality rates recorded in Italy for person-years adequate for the enrolment period. The standardized mortality ratio (SMR) determined the relative risk of death over that of the age and sex matched general population.
  
  
  
  Overall, 28/181 patients followed-up for a median period of 9.6years (range 1-25years) died. The 10 and 20-year overall 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 matched general 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 for decompensated of 6.70 (95% CI, 5.39-8.22).
  
  
  
  Patients with compensated HCV cirrhosis achieving SVR by IFN obtain a main benefit levelling their survival curve to that of the general population. Wider applicability of IFN-free regimens will possibly make this achievement more generalizable.
authors.affiliation: Humanitas University and IRCCS Istituto Clinico Humanitas, Rozzano, Italy. Electronic address: savino.bruno@hunimed.eu.
authors.forename: Savino
authors.initials: S
authors.lastname: Bruno
authors.affiliation: Sezione di Gastroenterologia e Epatologia, DIBIMIS, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Di Marco
authors.affiliation: UO Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Università degli Studi di Milano, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Iavarone
authors.affiliation: Dipartimento di Medicina, A.O. Istituti Clinici di Perfezionamento, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Roffi
authors.affiliation: Dipartimento di Medicina Interna, A.O. San Paolo, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Crosignani
authors.affiliation: Sezione di Gastroenterologia e Epatologia, DIBIMIS, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Calvaruso
authors.affiliation: UO Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Università degli Studi di Milano, Milan, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Aghemo
authors.affiliation: Sezione di Gastroenterologia e Epatologia, DIBIMIS, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cabibbo
authors.affiliation: UO Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Università degli Studi di Milano, Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Viganò
authors.affiliation: Humanitas University and IRCCS Istituto Clinico Humanitas, Rozzano, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Boccaccio
authors.affiliation: Sezione di Gastroenterologia e Epatologia, DIBIMIS, Università degli Studi di Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Craxí
authors.affiliation: UO Gastroenterologia ed Epatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Università degli Studi di Milano, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Colombo
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000401:mortality* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000401:mortality* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate; D000072230:Sustained Virologic Response
chemical_list: D007372:Interferons
keywords: Antiviral therapy; DAA’s; HCV-related cirrhosis; IFN-based therapy; SVR