Long-term follow-up results in chronic Hepatitis C virus infection

Background: Hepatitis C virus is a serious human pathogen with a prevalence of %2-3. The absence of vaccine, imperfect success of treatment modalities, the financial burden, hepatic/extrahepatic complications makes it still a major health problem all over the world. Sustained virological response (SVR) which is analyzed at the 24th week of treatment is one of the main targets of treatment. But there are many factors which affect survival rates, progression of the disease and development of SVR. Prediction of response to treatment gives the opportunity for the most appropriate, individualized and cost-effective treatment while preventing unnecessary / uneffective treatment interventions. The aim of our study is to investigate the predicted life expectancy of patients those treated in our institution and to find out factors that affect survival rates and SVR. Methods: 356 patients with chronic hepatitis C who evaluated in Dokuz Eylul University School of Medicine Department of Gastroenterology between 1992 and 2013 were included in this study. Survival rates and parameters which could effect the response to treatment (age, gender, viral load at diagnosis, ALT values and the presence of liver cirrhosis at the time of diagnosis) were evaluated. Using these parameters the correlation between predicted survival rates and SVR was investigated. Results: A significantly longer predicted life expectancy was seen in patients who received treatment than untreated patients. Longer predicted life expectancy was seen also in patients who has SVR than who hasn't. It was detected that the presence of cirrhosis at the time of diagnosis reduce not only predicted survival rates but also SVR rates. Neither predicted survival rates nor SVR were affected from the ALT values at the time of diagnosis. SVR was defined in %37 of patients. Although %21 of patients achieved end of treatment response, these patients couldn't access SVR. Gender and being younger than 40 years of age were not predictors of SVR, but a low baseline viral load ( HCV-RNA<600.000 IU/mL) was found to be associated with a significantly higher probability of achieving SVR Conclusion: SVR and cirrhosis are the most important factors which determining survival rates and predicted life expectancy. İndependent predictors for sustained virological response were cirrhosis and a low baseline viral load (HCV-RNA< 600.000 IU/ml).