Improved liver transplant waitlist mortality and lower risk of disease progression among chronic hepatitis C patients awaiting liver transplantation after the introduction of direct‐acting antiviral therapies in the United States

Summary Direct‐acting antiviral (DAA) therapies for chronic hepatitis C virus (HCV) infection achieve high cure rates, reducing HCV‐related disease progression to cirrhosis and hepatocellular carcinoma. We aim to evaluate the impact of DAAs on US liver transplant (LT) waitlist outcomes. We retrospec...

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Bibliographic Details
Published in:Journal of viral hepatitis 2019-03, Vol.26 (3), p.350-361
Main Authors: Young, Kellie, Liu, Benny, Bhuket, Taft, Gish, Robert G., Wong, Robert J.
Format: Article
Language:English
Subjects:
Antiviral agents
Antiviral Agents - therapeutic use
Antiviral drugs
Chronic infection
Cirrhosis
direct‐acting antivirals
Disease Progression
Female
Hepacivirus
Hepatitis
Hepatitis C
hepatitis C virus
Hepatitis C, Chronic - drug therapy
Hepatocellular carcinoma
Humans
Liver
Liver - pathology
Liver cancer
Liver cirrhosis
Liver transplantation
Liver Transplantation - mortality
Liver Transplantation - statistics & numerical data
Liver transplants
Male
Middle Aged
Mortality
Patients
Proportional Hazards Models
Registries
Regression analysis
Retrospective Studies
Risk assessment
Sex Factors
Transplants & implants
United States
UNOS/OPTN
Waiting Lists - mortality
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Summary:Summary Direct‐acting antiviral (DAA) therapies for chronic hepatitis C virus (HCV) infection achieve high cure rates, reducing HCV‐related disease progression to cirrhosis and hepatocellular carcinoma. We aim to evaluate the impact of DAAs on US liver transplant (LT) waitlist outcomes. We retrospectively evaluated US adults (age ≥18) with and without chronic HCV listed for LT before and after the widespread use of sofosbuvir, allowing a 6‐month period after approval (Era 1: 1/1/2002‐5/31/2014 vs Era 2: 6/1/2014‐12/31/2016) using the United Network for Organ Sharing registry. Overall, LT waitlist survival and likelihood of receiving LT were evaluated with multivariate Cox regression models. From 2002 to 2016, 158 045 patients were listed for LT. While the number of patients listed for HCV has been decreasing since 2012, the proportion of HCV patients with concurrent HCC is increasing by 3.33% per year (R2: 0.99, P 
ISSN:1352-0504
1365-2893
DOI:10.1111/jvh.13039