Long-term follow-up of patients with chronic hepatitis C treated with direct-acting antivirals: real-life study

• Grant number: 24/04504-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2024
• End date: July 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Fernanda Fernandes Souza
• Grantee: Rafael Gregório Arini
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

It is believed that in the coming years the natural history of hepatitis C virus (HCV) infection may be drastically modified due to the advent of direct-acting drugs with high rates of sustained virological response. In particular, with regard to the possibility of regression of liver fibrosis, even in more advanced stages of the disease, such as cirrhosis and complications. However, there is still a lack of studies in the Brazilian population that describe long-term outcomes, such as the development of hepatic decompensation and hepatocellular carcinoma after achieving virological cure. In this sense, the objective of this paper is to describe the long-term outcome of patients with chronic hepatitis C, based on their respective electronic medical records, treated with direct-acting antivirals at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HC-FMRP -USP) from 2016 to 2020. This is a retrospective cohort, with no experimental nature. The variables to be studied were divided into three categories: clinical-laboratory characteristics (age at the time of treatment, gender, HCV genotype, RNAHCV, staging of liver fibrosis before treatment, MELD and Child-Pugh scores, treatment data (scheme therapy, duration of treatment and response at the end of treatment) and outcomes in long-term follow-up (outpatient discharge, follow-up for screening for HCC or portal hypertension or development of complications such as: HCC, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy and digestive hemorrhage discharge, liver transplantation and death). Thus, the results of the present study may provide useful information in the development of screening strategies for portal hypertension and hepatocellular carcinoma in patients with chronic HCV infection who have achieved virological cure, as well as providing support for the development of public health policies in this context.