ArticlePloS one2025
Effect of sustained virologic response on liver-related mortality among individuals living with hepatitis C by treatment era: A population-based retrospective cohort study.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
purposeSustained virologic response (SVR) is a validated surrogate marker for successful hepatitis C virus (HCV) treatment. Historically, interferon-based therapies, the standard of care for decades, offered only limited efficacy with respect to SVR. The recent introduction of highly effective direct-acting antivirals (DAAs) revolutionised treatment, expanding treatment eligibility among individuals with advanced liver disease (ALD) and drug/alcohol-related substance use disorder. Given these clinical policy shifts, we assessed the real-world impact of SVR on liver-related death for these key clinical groups for whom treatment had previously been less feasible.
methodsWe conducted a population-based, cohort study of Ontario residents with HCV viremia between January 1st, 1999, and December 31st, 2018, with follow-up to May 31st, 2021 (N = 73,411) and used cause-specific hazard models to explore the association between SVR and liver-related death.
resultsSVR was associated with a significant reduction in liver-related deaths (adjusted hazard ratio [aHR]: 0.22, 95%CI: 0.20-0.24). This benefit was consistent across all levels of liver disease severity, including individuals with (aHR: 0.11, 95%CI: 0.06-0.18) and without (aHR: 0.13, 95%CI: 0.10-0.17) cirrhosis, individuals with ALD (aHR: 0.24, 95%CI: 0.22-0.27) as well as among individuals with (aHR: 0.24, 95%CI: 0.21-0.27) and without (aHR: 0.21, 95%CI: 0.18-0.24) substance use disorder.
conclusionsThis study demonstrates the real-world impact of SVR on liver-related mortality and highlights the value of early treatment and continued support for populations who are marginalised.
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