title: Impact of virus eradication in patients with compensated hepatitis C virus-related cirrhosis: competing risks and multistate model.
abstract: No published study to date has provided a careful analysis of the effects of a sustained viral response (SVR) on the outcomes of patients with compensated hepatitis C virus (HCV)-related cirrhosis in relation to the degree of portal hypertension. Therefore, we estimated the impact of achieving SVR on disease progression, hepatocellular carcinoma (HCC) development and mortality in a large cohort of HCV patients with cirrhosis with or without oesophageal varices (OVs) at the start of antiviral therapy.
  
  
  
  A total of 535 Caucasian patients were prospectively recruited to this study. All patients had a clinical or histological diagnosis of compensated HCV-related cirrhosis and underwent interferon-based therapy. Competing risks and a multistate model were analysed according to the presence or absence of OVs at baseline.
  
  
  
  Compared to patients without SVR, a greater proportion of patients who achieved SVR showed no liver disease progression after 10 years (36.3% vs. 61.3% of patients without baseline OVs; 29.6% vs. 64.3% of patients with baseline OVs). Achievement of SVR was significantly associated with reduced occurrence rates of de-novo OVs, hepatic decompensation and HCC. Compared to patients without SVR, patients with SVR had lower likelihoods of liver-related death at 10 years (20.6% vs. 10.3% of patients without baseline OVs; 50.5% vs. 21.8% of patients with baseline OVs).
  
  
  
  In patients with compensated HCV-related cirrhosis with or without OVs at baseline, SVR is associated with reduced disease progression and liver-related mortality.
authors.affiliation: Sezione di GAstroenterologia e Epatologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Petta
authors.affiliation: Sezione di GAstroenterologia e Epatologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Di Marco
authors.affiliation: Humanitas University and Humanitas Research Hospital Rozzano, Milan, Italy.
authors.forename: Savino
authors.initials: S
authors.lastname: Bruno
authors.affiliation: Consiglio Nazionale delle Ricerche, Istituto per l'Ambiente Marino Costiero, Mazara del Vallo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Enea
authors.affiliation: Sezione di GAstroenterologia e Epatologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Calvaruso
authors.affiliation: Humanitas University and Humanitas Research Hospital Rozzano, Milan, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Boccaccio
authors.affiliation: Humanitas University and Humanitas Research Hospital Rozzano, Milan, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Rossi
authors.affiliation: Sezione di GAstroenterologia e Epatologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Craxì
authors.affiliation: Sezione di GAstroenterologia e Epatologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy.
authors.forename: Calogero
authors.initials: C
authors.lastname: Cammà
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000821:virology; D018450:Disease Progression; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007558:Italy; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000821:virology; D008113:Liver Neoplasms / Q000401:mortality* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000072230:Sustained Virologic Response
chemical_list: D000998:Antiviral Agents
keywords: 
  HCV
  ; 
  SVR
  ; cirrhosis; multistate