الفهرس 
List of AbbreviationOnly 14 pages are availabe for public view
 |  | from | 44 |  |  |
| | | from | 44 | | |
Abstract
The eradication of hepatitis C virus (HCV) following the introduction of generic direct-acting antivirals (DAAs) in Egypt is associated with a substantial decline in liver-related morbidity and mortality. However, data on the extent of long-term outcomes of liver disease in patients with sustained virologic response (SVR) from real-life cohorts are limited. Objective(s): This study was designed to examine the long-term outcomes of generic DAA-induced virological cure in a real-life cohort of patients with chronic HCV infection with or without underlying schistosomiasis. Methods: We conducted a prospective study (March 2019 to April 2020) at a liver center and the National Medical Institute in El-Behira Governorate, Egypt. We enrolled a cohort of 506 recently cured patients with chronic HCV infection (including 437 Child–Pugh class A [Child-A] and 69 Child–Pugh class B [Child-B]). All patients were clinically evaluated at different time points during the 2–year follow-up. Results: At baseline, 40.5% of the patients were cirrhotic, and 62.5% had schistosomal hepatic fibrosis. Over the course of treatment and follow-up, 77 (15.2%) patients (42 [9.6%] Child-A and 35 [50.7%] Child-B) experienced complications at different time points. The overall mortality rate was approximately 1/1,000 person-years. The incidence of hepatic insufficiency was approximately 5.5/1,000 person-years, and that of de novo hepatocellular carcinoma (HCC) was approximately 8.3/1,000 person-years. A sustained improvement in liver indices up to 2 years of follow-up was observed. In the Cox regression model, pretreatment decompensated cirrhosis, male gender, and baseline alpha-fetoprotein (AFP) level predicted the occurrence of adverse liver events and HCC after therapy. Conclusion: Generic DAA-induced SVR remains robust with favorable clinical outcomes and stabilization in patients compensated and decompensated liver diseases, although the risk of hepatocarcinogenesis cannot be eliminated. Surveillance of patients with treated HCV infection is an important aspect of post-cure care for early detection and management of liver disease-related adverse events.