Decreasing mortality and disease severity in hepatitis C patients awaiting liver transplantation in the United States

Decreasing mortality and disease severity in hepatitis C patients awaiting liver transplantation... Hepatitis C virus (HCV) infection has been the leading indication for liver transplantation (LT) in the United States. Since 2013, interferon‐free antiviral therapy has led to sustained virological response in many LT candidates. We compared the wait‐list mortality of HCV patients with that of patients with other chronic liver diseases. Data for primary LT candidates were obtained from the Organ Procurement and Transplantation Network database. Adult wait‐list registrants were divided into 3 cohorts: cohort 1 included patients on the waiting list as of January 1, 2004; cohort 2 as of January 1, 2009; and cohort 3 as of January 1, 2014. The primary outcome was wait‐list mortality, and the secondary outcome was the rate of change in Model for End‐Stage Liver Disease (MELD). Multivariate Cox proportional hazards analysis was performed to evaluate 12‐month wait‐list mortality. The cohorts included 7627 LT candidates with HCV and 13,748 patients without HCV. Compared with cohort 2, HCV patients in cohort 3 had a 21% lower risk of death (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.67‐0.93). Among patients with non‐HCV liver disease, no difference in mortality was seen between cohorts 2 and 3 (HR, 0.97; 95% CI, 0.86‐1.09). Among HCV patients, the mean rate of change in MELD decreased from 2.35 per year for cohort 2 to 1.90 per year for cohort 3, compared with 1.90 and 1.66 in cohorts 2 and 3, respectively, among non‐HCV patients. In this population‐based study, wait‐list mortality and progression of disease severity decreased in recent HCV patients for whom direct‐acting antiviral agents were available. Liver Transplantation 24 735–743 2018 AASLD. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Liver Transplantation Wiley

Decreasing mortality and disease severity in hepatitis C patients awaiting liver transplantation in the United States

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Publisher
Wiley
Copyright
© 2018 by the American Association for the Study of Liver Diseases.
ISSN
1527-6465
eISSN
1527-6473
D.O.I.
10.1002/lt.24973
Publisher site
See Article on Publisher Site

Abstract

Hepatitis C virus (HCV) infection has been the leading indication for liver transplantation (LT) in the United States. Since 2013, interferon‐free antiviral therapy has led to sustained virological response in many LT candidates. We compared the wait‐list mortality of HCV patients with that of patients with other chronic liver diseases. Data for primary LT candidates were obtained from the Organ Procurement and Transplantation Network database. Adult wait‐list registrants were divided into 3 cohorts: cohort 1 included patients on the waiting list as of January 1, 2004; cohort 2 as of January 1, 2009; and cohort 3 as of January 1, 2014. The primary outcome was wait‐list mortality, and the secondary outcome was the rate of change in Model for End‐Stage Liver Disease (MELD). Multivariate Cox proportional hazards analysis was performed to evaluate 12‐month wait‐list mortality. The cohorts included 7627 LT candidates with HCV and 13,748 patients without HCV. Compared with cohort 2, HCV patients in cohort 3 had a 21% lower risk of death (hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.67‐0.93). Among patients with non‐HCV liver disease, no difference in mortality was seen between cohorts 2 and 3 (HR, 0.97; 95% CI, 0.86‐1.09). Among HCV patients, the mean rate of change in MELD decreased from 2.35 per year for cohort 2 to 1.90 per year for cohort 3, compared with 1.90 and 1.66 in cohorts 2 and 3, respectively, among non‐HCV patients. In this population‐based study, wait‐list mortality and progression of disease severity decreased in recent HCV patients for whom direct‐acting antiviral agents were available. Liver Transplantation 24 735–743 2018 AASLD.

Journal

Liver Transplantation – Wiley

Published: Jan 1, 2018

References

  • Current management of hepatitis C virus: regimens for peri‐liver transplant patients
    Saxena, V; Terrault, N
  • Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010
    Denniston, MM; Jiles, RB; Drobeniuc, J; Klevens, RM; Ward, JW; McQuillan, GM; Holmberg, SD
  • Hepatitis C virus infection in USA: an estimate of true prevalence
    Chak, E; Talal, AH; Sherman, KE; Schiff, ER; Saab, S
  • Increasing prevalence of cirrhosis among U.S. adults aware or unaware of their chronic hepatitis C virus infection
    Udompap, P; Mannalithara, A; Heo, NY; Kim, D; Kim, WR
  • Projected future increase in aging hepatitis C virus‐infected liver transplant candidates: a potential effect of hepatocellular carcinoma
    Biggins, SW; Bambha, KM; Terrault, NA; Inadomi, J; Shiboski, S; Dodge, JL
  • OPTN/SRTR 2013 annual data report: liver
    Kim, WR; Lake, JR; Smith, JM; Skeans, MA; Schladt, DP; Edwards, EB
  • Association between sustained virological response and all‐cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis
    Meer, AJ; Veldt, BJ; Feld, JJ; Wedemeyer, H; Dufour, JF; Lammert, F
  • Efficacy of antiviral therapy on hepatitis C recurrence after liver transplantation: a randomized controlled study
    Carrión, JA; Navasa, M; García‐Retortillo, M; García‐Pagan, JC; Crespo, G; Bruguera, M
  • Pegylated‐interferon and ribavirin in liver transplant candidates and recipients with HCV cirrhosis: systematic review and meta‐analysis of prospective controlled studies
    Xirouchakis, E; Triantos, C; Manousou, P; Sigalas, A; Calvaruso, V; Corbani, A
  • Ledipasvir and sofosbuvir plus ribavirin for treatment of HCV infection in patients with advanced liver disease
    Charlton, M; Everson, GT; Flamm, SL; Kumar, P; Landis, C; Brown, RS
  • Variation in access to the liver transplant waiting list in the United States
    Mathur, AK; Ashby, VB; Fuller, DS; Zhang, M; Merion, RM; Leichtman, A; Kalbfleisch, J
  • Racial disparities in treatment rates for chronic Hepatitis C: analysis of a population‐based cohort of 73,665 patients in the United States
    Vutien, P; Hoang, J; Brooks, L; Nguyen, NH; Nguyen, MH
  • Changing trends in complications of chronic hepatitis C
    Lu, M; Li, J; Rupp, LB; Zhou, Y; Holmberg, SD; Moorman, AC
  • The epidemiology of cirrhosis in the United States: a population‐based study
    Scaglione, S; Kliethermes, S; Cao, G; Shoham, D; Durazo, R; Luke, A; Volk, ML
  • OPTN/SRTR 2015 annual data report: liver
    Kim, WR; Lake, JR; Smith, JM; Skeans, MA; Schladt, DP; Edwards, EB
  • Ledipasvir‐sofosbuvir with or without ribavirin to treat patients with HCV genotype 1 infection and cirrhosis non‐responsive to previous protease‐inhibitor therapy: a randomised, double‐blind, phase 2 trial (SIRIUS)
    Bourlière, M; Bronowicki, JP; Ledinghen, V; Hézode, C; Zoulim, F; Mathurin, P
  • Ledipasvir and sofosbuvir in patients with genotype 1 hepatitis C virus infection and compensated cirrhosis: an integrated safety and efficacy analysis
    Reddy, KR; Bourlière, M; Sulkowski, M; Omata, M; Zeuzem, S; Feld, JJ
  • Management of hepatitis C before and after liver transplantation in the era of rapidly evolving therapeutic advances
    Bunchorntavakul, C; Reddy, KR
  • Treatment of chronic hepatitis C in special populations
    Bunchorntavakul, C; Tanwandee, T
  • Safety and efficacy of sofosbuvir‐containing regimens in hepatitis C infected patients with impaired renal function
    Saxena, V; Koraishy, FM; Sise, ME; Lim, JK; Schmidt, M; Chung, RT
  • Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease: a multicentre, open‐label, randomised, phase 2 trial
    Manns, M; Samuel, D; Gane, EJ; Mutimer, D; McCaughan, G; Buti, M
  • Adefovir dipivoxil therapy for lamivudine‐resistant hepatitis B in pre‐ and post‐liver transplantation patients
    Schiff, ER; Lai, CL; Hadziyannis, S; Neuhaus, P; Terrault, N; Colombo, M
  • Sustained virologic response to interferon‐free therapies ameliorates HCV‐induced portal hypertension
    Mandorfer, M; Kozbial, K; Schwabl, P; Freissmuth, C; Schwarzer, R; Stern, R
  • Eradication of hepatitis C virus infection in patients with cirrhosis reduces risk of liver and non‐liver complications
    Nahon, P; Bourcier, V; Layese, R; Audureau, E; Cagnot, C; Marcellin, P
  • Reversion of disease manifestations after HCV eradication
    Meer, AJ; Berenguer, M
  • Delisting of liver transplant candidates with chronic hepatitis C after viral eradication: a European study
    Belli, LS; Berenguer, M; Cortesi, PA; Strazzabosco, M; Rockenschaub, SR; Martini, S
  • Reduction in liver transplant wait‐listing in the era of direct‐acting antiviral therapy
    Flemming, JA; Kim, WR; Brosgart, CL; Terrault, NA

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