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dc.contributor.authorJohnson, PJ
dc.contributor.authorBerhane, S
dc.contributor.authorWalker, AJ
dc.contributor.authorGordon, FH
dc.contributor.authorRyder, SD
dc.contributor.authorMcPherson, S
dc.contributor.authorSreedharan, A
dc.contributor.authorUstianowski, AA
dc.contributor.authorAgarwal, K
dc.contributor.authorMutimer, D
dc.contributor.authorKumada, T
dc.contributor.authorToyoda, H
dc.contributor.authorIrving, WL
dc.contributor.authorAgarwal, K
dc.contributor.authorAldersley, M
dc.contributor.authorAla, A
dc.contributor.authorAspinall, R
dc.contributor.authorBarnes, E
dc.contributor.authorBrown, A
dc.contributor.authorCorless, L
dc.contributor.authorCramp, Matthew
dc.contributor.authorForton, D
dc.contributor.authorFoster, G
dc.contributor.authorFoxton, M
dc.contributor.authorGelson, W
dc.contributor.authorGorard, D
dc.contributor.authorGordon, F
dc.contributor.authorKhakoo, S
dc.contributor.authorLawson, A
dc.contributor.authorMcPherson, S
dc.contributor.authorMoreea, S
dc.contributor.authorMutimer, D
dc.contributor.authorPrince, M
dc.contributor.authorRichardson, P
dc.contributor.authorRosenberg, W
dc.contributor.authorRyder, S
dc.contributor.authorSreedharan, A
dc.contributor.authorStone, B
dc.contributor.authorUstianowski, A
dc.contributor.authorVerma, S
dc.contributor.authorWiselka, M
dc.date.accessioned2022-01-20T12:08:23Z
dc.date.issued2021-01
dc.identifier.issn1345-2533
dc.identifier.issn1365-2893
dc.identifier.urihttp://hdl.handle.net/10026.1/18589
dc.description.abstract

<jats:title>Abstract</jats:title><jats:p>Whilst the benefit of direct‐acting antiviral agents (DAAs) in achieving sustained virological response (SVR) is now well‐accepted, their impact on liver function, particularly in relation to achievement of SVR, has not been well documented. We studied 2394 patients with chronic HCV infection, 1276 receiving DAAs and 1118 interferon‐based therapy. Liver function was assessed by the albumin‐bilirubin (ALBI) score or grade. Overall survival according to SVR status and baseline ALBI grade was examined. We also studied time to first decompensation according to ALBI grade, as well as longitudinal changes in ALBI score over time according to SVR. Among the patients receiving DAAs, 89% achieved SVR (Japan = 99%, UK = 78%). Amongst the decompensated patients in the UK cohort, three distinct risk groups according to ALBI grade at baseline were observed. The UK patients receiving DAAs, who had predominantly decompensated disease, showed clear evidence of improvement of liver function detectable within 2 years of the start of treatment, especially in those achieving SVR. These early changes in liver function were very similar to those observed in the first 2‐3 years after interferon‐based therapy. DAAs improve liver function especially in those with decompensated disease who achieve SVR. Experience with interferon‐based therapy suggests that failure to achieve SVR is associated with long‐term decline in liver function and, in contrast, patients who do achieve SVR can expect long‐term disease improvement and subsequent stabilization of liver function. Our initial analysis suggests that those receiving DAAs are likely, in the long term, to follow a similar course.</jats:p>

dc.format.extent168-176
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherWiley
dc.subjectALBI score
dc.subjectdirect-acting antivirals
dc.subjecthepatitis C virus
dc.subjectinterferon therapy
dc.subjectliver function
dc.subjectsustained virological response
dc.subjectAntiviral Agents
dc.subjectBilirubin
dc.subjectHepacivirus
dc.subjectHepatitis C, Chronic
dc.subjectHumans
dc.subjectSustained Virologic Response
dc.titleImpact of direct‐acting antiviral agents on liver function in patients with chronic hepatitis C virus infection
dc.typejournal-article
dc.typeJournal Article
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/32978982
plymouth.issue1
plymouth.volume28
plymouth.publication-statusPublished
plymouth.journalJournal of Viral Hepatitis
dc.identifier.doi10.1111/jvh.13408
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CBR
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2020-08-17
dc.rights.embargodate2022-1-21
dc.identifier.eissn1365-2893
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1111/jvh.13408
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2021-01
rioxxterms.typeJournal Article/Review


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