Despite the fact that an increasingly large portion of the hepatitis-C-infected population successfully achieves a cure
for the infection, called sustained viral response (SVR), this population still deals with increased mortality rates. A status of SVR means that the hepatitis C virus is no longer detected in the bloodstream during treatment and is also not detectable at 12 weeks or more after completing treatment, although patients will retain the hepatitis C antibody for life. With achievement of SVR, liver damage ceases, liver function improves, and there is a much lower risk of liver-related complications and death, although SVR status does not guarantee that any existing scarring will heal.
Given the positive prognosis that comes with SVR, it is surprising that SVR patients in a Scottish study
still faced mortality rates 1.9 times more frequent than the general population. The researchers who conducted the study noted that about two-thirds of the “excess deaths” could be attributed to either liver cancer or “modifiable characteristics” such as heavy alcohol and drug use, suggesting that hepatitis C patients who have been “cured” of the infection could benefit from continued monitoring from health professionals and a direct address of the lifestyle risk factors that may have led to the infection in the first place.
To analyze mortality rates in SVR patients, the research team followed 1,824 patients who had attained SVR between 1996 and 2011. All patients began and then terminated a course of interferon (IFN)-based antiviral therapy between January 1996 and December 2010, and all showed compensated liver disease at the time of completion of the treatment. This meant that their livers may have been damaged but they were still functional. Patients also showed no HIV or hepatitis B co-infections, and the study began nine months after the antiviral treatment stopped in order to fully verify SVR status.
In the 5.2 years of the study, the predominantly male (67%) population experienced 78 deaths, a relatively high number given the median age of 40.7 years. “The number of deaths that would have been expected in our SVR cohort given general population mortality rates was 42,” said the team, noting that “significant elevations [in mortality] were observed for death due to primary liver cancer and death due to drug-related causes.”