Retrospective single-centre study on patients with advanced fibrosis treated with direct-acting antiviral agents for hepatitis C between 2015 and 2022

Abstract

Background Patients treated with direct acting antivirals for hepatitis C exhibit high cure rates and improved survival. However, there is limited knowledge on their long-term clinical evolution. Aims In this study, we aimed to analyse the risk of hepatocarcinoma and hepatic decompensation in patients treated with direct acting antivirals. Methods We conducted a retrospective single-centre study of Portuguese patients with advanced fibrosis treated with direct-acting antiviral agents between 2015 and 2022 at a tertiary hospital. Results Out of 460 patients, 50 developed hepatocarcinoma and 36 experienced hepatic decompensation. The risk for hepatocarcinoma was higher in patients aged over 55 (HR 4.87, 95% CI 2.34-10.13, p<0.001), with signs of portal hypertension (HR 3.83, 95% CI 2.05-7.13, p<0.001) and arterial hypertension (HR 1.98, 95% CI 1.09-3.58, p=0.024). Alcohol consumption (HR 3.30, 95% CI 1.22-8.94, p=0.019), signs of portal hypertension (HR 4.56, 95% CI 2.19-9.48, p<0.001) and hepatocarcinoma (HR 3.47, 95% CI 1.69-7.10, p<0.001) increased the risk of hepatic decompensation. Conclusion We identified several risk factors for hepatocarcinoma and hepatic decompensation, emphasizing their importance in the clinical management of these patients.