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Gastroenterology. 2018 Oct 24. pii: S0016-5085(18)35166-7. doi: 10.1053/j.gastro.2018.10.033. [Epub ahead of print]

What are the Benefits of a Sustained Virologic Response to Direct-acting Antiviral Therapy for HCV Infection?

Author information

1
Division of Gastroenterology; Department of Medicine Veterans Affairs Puget Sound Healthcare System and University of Washington, Seattle WA; Research and Development, Veterans Affairs Puget Sound Healthcare System, Seattle WA. Electronic address: georgei@medicine.washington.edu.
2
. Toronto Centre for Liver Disease, University Health Network, Sandra Rotman Centre for Global Health, University of Toronto.

Abstract

Direct-acting antiviral (DAA) regimens are safe and effective at eradicating hepatitis C virus (HCV) infection. Unfortunately, DAAs remain expensive, so treatment of all HCV-infected patients would substantially affect healthcare costs. It is therefore critical to continue to assess hepatic and extrahepatic benefits of DAA-induced sustained virologic responses (SVRs). DAA-induced SVRs results reduces patients' risk of cirrhosis and hepatocellular carcinoma and many extra-hepatic manifestations of HCV infection; there are also data that an SVR reduces mortality. SVR is a relevant clinical endpoint, but further analyses are required to confirm its importance among diverse HCV-infected populations and to document the public health benefits of HCV elimination at the population level. We review the evidence for the benefits associated with SVRs in different clinical settings and challenges to data collection.

KEYWORDS:

HCC; epidemiology; liver; long-term outcome

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