Evaluating long-term outcomes of direct-acting antiviral therapy in chronic hepatitis C: A retrospective study

Direct-acting antiviral (DAA) therapy is now the recommended standard for chronic hepatitis C (CHC), demonstrating remarkable efficacy. Nonetheless, there is a relative lack of information concerning the sustained, long-term consequences of DAA treatment. Therefore, this study sought to investigate the long-term impact of DAA therapy on patients with CHC. We conducted a retrospective review of CHC patients who received DAA therapy at Samsung Changwon Hospital. Patients with preexisting hepatocellular carcinoma (HCC) and those lost to follow-up were excluded. Demographic, clinical, and virological data were analyzed, focusing on DAA treatment outcomes, liver fibrosis, and the relationship with HCC development. A total of 223 patients were included: 59.5% with CHC genotype 1, 93.3% treatment-naïve, and 26.5% with liver cirrhosis (LC). Treatment included asunaprevir and daclatasvir in 46.2%, with 46.2% receiving a 12-week regimen. Sustained virological response at 12 weeks (SVR12) was achieved in 97.8%, with 5 treatment failures. Post-treatment, APRI scores < 0.7 increased (68.2% vs 87.7%, P < .001), as did FIB-4 scores < 3.25 (60.1% vs 80.3%, P < .001). During follow-up, 9 patients developed HCC, with serum sodium identified as a risk factor (odds ratio: 0.6; confidence interval: 0.41-0.88; P = .008). DAA treatment effectively treats CHC and reduces liver fibrosis. However, further research is warranted to better understand and predict the development of HCC.