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Post Info TOPIC: Cool paper
movebo


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Cool paper
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Hi Tig,

yes, absolutely, it will be even better, we live in exciting times.

People who are just diagnosed read all over the internet that no regression is possible, that cirrhosis is progressive,
and one can find tables with frightening survival estimates.

This paper has hard data, showing that even with the old (IFN) treatments, compensated cirrhotics with SVR are
no more likely to die long term (~20 years) than people in the general population of the same age etc.

Pretty good ...

Cheers,
Tom

__________________

M, 57 (@Dx, 2014)

7/14: VL 4E6, F0-2 MRI TE

8/15: biopsy, A2F4 (no good)

SOT 8/15 - Harv./RIBA 12 wks

12 wks post: UND, ALT 21, AST 21, GGT 23, platelets 206

5/19 (44 month post): UND, ALT 34(?), AST 24,  GGT 22, platelets 240 
Tig


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Hi Tom,

It's interesting to read these techinal reports. The results are over 2 decades and in that time the standards of care have changed dramatically, especially over the last. That doesn't include the advances through trial investigation and improvements in medical care overall. 

We're witnessing rapid improvements in medicine in general and these mortality ratios will change significantly for the better, in my opinion. We are already seeing fibrosis regression after SVR, something that hadn't been considered possible decades ago. We have our own example here of fibrosis regression from F4 to F3 (cirrhosis to non cirrhotic). 

So I believe the future holds some pleasant and positive improvements for all that achieve SVR. 



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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movebo


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Hi All,  

have a look at the abstract below, just came out. The kind of paper I like to see. When I was told I am F4 I googeled it, as one does, and stopped rather quickly, in a very somber mood. Looks like things are not quite as bad with SVR, hopefully.

Cheers, Tom

Survival of patients with HCV cirrhosis and sustained virologic response is similar to the general population

Background & Aims: 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. Methods: 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. Results: Overall, 28/181 patients followed-up for a median period of 9.6 years (range 125 years) died. The 10 and 20-year overall survival rates for the whole series were 90.9% (95% CI, 84.394.8) and 62.9% (95% CI, 45.975.9), 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, 0.721.35), with an SMR for non-SVR patients of 3.85 (95% CI, 3.434.30), for untreated of 3.01 (95% CI, 2.643.42) and for decompensated of 6.70 (95% CI, 5.398.22). Conclusions: 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. Bruno S et al.  J Hepatol (2016), http://dx.doi.org/10.1016/j.jhep.2016.01.034

 



__________________

M, 57 (@Dx, 2014)

7/14: VL 4E6, F0-2 MRI TE

8/15: biopsy, A2F4 (no good)

SOT 8/15 - Harv./RIBA 12 wks

12 wks post: UND, ALT 21, AST 21, GGT 23, platelets 206

5/19 (44 month post): UND, ALT 34(?), AST 24,  GGT 22, platelets 240 
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