ArticleAlimentary pharmacology & therapeutics2020
Hepatitis C eradication with direct-acting anti-virals reduces the risk of variceal bleeding.
Article in Alimentary pharmacology & therapeutics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- CROATIAN GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF PORTAL HYPERTENSION.Acta clinica Croatica · 2024Guideline
- Efficacy and Safety of Ligation Combined With Sclerotherapy for Patients With Acute Esophageal Variceal Bleeding in Cirrhosis: A Meta-Analysis.Frontiers in surgery · 2021Pooled it
- Direct-acting antiviral therapy reduces variceal rebleeding and improves liver function in hepatitis C virus-related cirrhosis: A multicenter retrospective cohort study.World journal of hepatology · 2025Article
- Evolution of Liver Fibrosis in Romanian HCV Patients Following Treatment with Direct-Acting Antivirals.Journal of clinical medicine · 2025Article
- Role of etiological therapy in achieving recompensation of decompensated liver cirrhosis.World journal of hepatology · 2025Review
- Direct-acting antiviral agent use and gastrointestinal safety in patients with chronic hepatitis C: a pharmacovigilance study based on FDA Adverse Event Reporting System.International journal of clinical pharmacy · 2023Article
- Article
- Liver-related complications before and after successful treatment of chronic hepatitis C virus infection in people with inherited bleeding disorders.Haemophilia : the official journal of the World Federation of Hemophilia · 2023Article
- Effect of Direct-Acting Antiviral Agents on Gastroesophageal Varices in Patients with Hepatitis C Virus-Related Cirrhosis.Medicina (Kaunas, Lithuania) · 2022Article
- Fibrosis regression following hepatitis C antiviral therapy.World journal of hepatology · 2022Review
- Screening and surveillance of oesophageal varices in patients with HCV-positive liver cirrhosis successfully treated by direct-acting antiviral agents.Liver international : official journal of the International Association for the Study of the Liver · 2022Article
- Therapy of Chronic Viral Hepatitis: The Light at the End of the Tunnel?Biomedicines · 2022Review
- Observational
- Noninvasive Risk Stratification After HCV Eradication in Patients With Advanced Chronic Liver Disease.Hepatology (Baltimore, Md.) · 2021Article
- Fibrosis Regression After Eradication of Hepatitis C Virus: From Bench to Bedside.Gastroenterology · 2021Review
- Long-term Effect of the HCV Elimination With Direct-acting Antivirals on the Progression of Gastroesophageal Varices.In vivo (Athens, Greece)Article
Corrections and comments
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5 authors.
Funding
Abstract
backgroundThe real-world, long-term benefits of sustained virologic response (SVR) on the risk of variceal bleeding remain unclear.
aimTo assess the association between DAA-induced SVR and post-treatment variceal bleeding
methodsWe identified patients who initiated DAA-only anti-viral treatments in the United States Veterans Affairs healthcare system from 2013 to 2015. We followed patients until 1 January 2019 for the development of gastro-oesophageal variceal bleeding defined by diagnostic codes. We used multivariable Cox proportional hazards regression to assess the association between SVR and development of variceal bleeding, adjusting for potential confounders.
resultsAmong 33 582 DAA-treated patients, 549 (1.6%) developed variceal bleeding after treatment (mean follow-up 3.1 years). Compared to no SVR, SVR was associated with a significantly lower incidence of variceal bleeding among all patients (0.46 vs 1.26 per 100 patient-years, adjusted hazard ratio [AHR] 0.66, 95% CI 0.52-0.83), among patients with pre-treatment cirrhosis (1.55 vs 2.96 per 100 patient-years, AHR 0.73, 95% CI 0.57-0.93) and among patients without pre-treatment cirrhosis (0.07 vs 0.29 per 100 patient-years, AHR 0.33, 95% CI 0.17-0.65). The risk of variceal bleeding after treatment was lower in those who achieved SVR vs no SVR among patients who had non-bleeding varices (3.5 vs 4.9 per 100 patient-years) or bleeding varices (12.9 vs 16.4 per 100 patient-years) diagnosed before treatment, but these differences were not statistically significant in adjusted analyses.
conclusionDAA-induced SVR is independently associated with a lower risk of variceal bleeding during long-term follow-up in patients with and without pre-treatment cirrhosis. These findings demonstrate an important real-world benefit of DAA treatment.
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