Long-term prognosis of liver disease in patients with eradicated chronic hepatitis C virus: An analysis using a Markov chain model
- 1 August 2020
- journal article
- research article
- Published by Wiley in Hepatology Research
- Vol. 50 (8), 936-946
- https://doi.org/10.1111/hepr.13512
Abstract
Aim The long-term prognosis of patients with chronic hepatitis C virus (HCV) infection who have received antiviral therapy and who demonstrate HCV eradication remains incompletely characterized. In this study, we investigated the long-term prognosis of liver disease in patients with eradication of HCV. Methods A total of 552 patients with chronic HCV infection (6815 person-years) who were treated with interferon-based therapy and who achieved sustained virologic response were included. Yearly transition probabilities for each liver state (chronic hepatitis, cirrhosis, and hepatocellular carcinoma [HCC]) were calculated using a Markov chain model. Results In the analysis of 1-year liver disease state transition probabilities, progression to cirrhosis occurred in 0.5-2.1% of male patients with chronic hepatitis across all age groups. In male patients with cirrhosis, HCC developed in 0.6-1.9% of patients over the age of 50 years. In female patients with chronic hepatitis, progression to cirrhosis occurred in 0.4-2.1% of patients across all age groups. In addition, in female patients with cirrhosis, HCC developed in those aged 60-69 (0.4%) and 70-79 (0.4%) years. Under the assumption of either a chronic hepatitis or cirrhosis state at age 40 or 60 years as the starting condition for simulation over the next 40 or 20 years, respectively, the probability of HCC gradually increased with age and was higher in male patients. Conclusions The development or progression of cirrhosis and the development of HCC are risks in HCV patients despite HCV eradication, not only in those with cirrhosis but also in those with chronic hepatitis.This publication has 45 references indexed in Scilit:
- Surveillance algorithm and diagnostic algorithm for hepatocellular carcinomaHepatology Research, 2010
- FIB-4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotestHepatology, 2007
- Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfectionHepatology, 2006
- Hepatocellular Carcinoma: Epidemiology, Risk Factors, and ScreeningSeminars in Liver Disease, 2005
- A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis CHepatology, 2003
- Natural histories of hepatitis C virus infection in men and women simulated by the Markov modelJournal of Medical Virology, 2003
- Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive modelHepatology, 2002
- Platelet count reflects stage of chronic hepatitis CHepatology Research, 1999
- Prognosis of chronic hepatitis c: Results of a large, prospective cohort studyHepatology, 1998
- Markov Models in Medical Decision MakingMedical Decision Making, 1993