522. Fibrosis Progression and Incidence of Cirrhosis and Hepatic Decompensation in Persons Treated with Paritaprevir/Ritonavir/Ombitasvir/Dasabuvir: Results from ERCHIVES
Session: Poster Abstract Session: Hepatitis B and C in Varied Settings
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • Poster# 522_IDSA2017_#63482_Fibrosis Progression.pdf (773.3 kB)
  • Fibrosis Progression and Incidence of Cirrhosis and Hepatic Decompensation in Persons Treated with Paritaprevir/Ritonavir/Ombitasvir/Dasabuvir: Results from ERCHIVES

    Tracey G. Simon, MD

    Peng Yan, MS

    Jens Kort, MD, PhD

    Adeel A. Butt, MD, MS

     

    Abstract #63482

     

    Background: Data are limited regarding the effect of paritaprevir/ritonavir, ombitasvir, dasabuvir regimen (PrOD) upon the rate of liver fibrosis progression and incidence of cirrhosis and hepatic decompensation after treatment for HCV.

    Methods: Within ERCHIVES (Electronically Retrieved Cohort of HCV Infected Veterans), we identified HCV infected persons treated with PrOD and treatment-na•ve controls to determine the effect of PrOD treatment upon subsequent progression of fibrosis and incident cirrhosis and hepatic decompensation. Controls were propensity-score matched based on demographic and clinical characteristics. We excluded those with HIV coinfection, positive HBsAg, hepatocellular carcinoma at baseline and those with missing HCV RNA or FIB-4 scores. Fibrosis progression and liver cirrhosis were assessed using the FIB-4 score.

    Results: The final propensity score matched sample included 1,473 PrOD-treated individuals, and an equal number of matched, untreated controls. PrOD-treated patients had significantly reduced median FIB-4 scores over time, compared to controls (median absolute change in FIB-4 = -0.7 [IQR -1.51, -0.3] vs. +0.06 [IQR -0.38, 0.49]; P<0.0001). Compared to matched controls, PrOD-treated patients had an 86% relative reduction in the risk of incident cirrhosis over 2,241 patient-years of follow-up (adjusted HR 0.14 [95% CI 0.08-0.23]). Treatment with PrOD was also associated with delayed time to first hepatic decompensation event (P<0.001). In sensitivity analysis, the exclusion of patients with baseline cirrhosis did not materially alter the estimates of effect.

    Conclusion: Treatment with PrOD is associated with a significant reduction in fibrosis progression, a longer time to the development of cirrhosis, and reduced risk of hepatic decompensation. Our results demonstrate the long-term anti-fibrotic benefits associated with PrOD therapy for chronic HCV.

    Tracey Simon, MD, Gastroenterology and Hepatology, Massachusetts General Hospital, Boston, MA, Peng Yan, MS, VA Pittsburgh Healthcare System, Pittsburgh, PA, Jens Kort, MD, PhD, AbbVie Inc., North Chicago, IL and Adeel Butt, MD, MS, Weill Cornell Medical College, New York, NY; Hamad Medical Corporation, Doha, Qatar

    Disclosures:

    T. Simon, None

    P. Yan, None

    J. Kort, Abbvie: Employee and Shareholder , Salary

    A. Butt, Merck: Investigator , Grant recipient

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.