Survival benefit of DAA-induced SVR in patients with decompensated cirrhosis

Survival benefits of DAA in patients with decompensated cirrhosis
Kim WR, EASL 2018, Abs. PS-151




  • Incidence of deaths in DAA-treated patients with decompensated cirrhosis (Child-Pugh B or C) from LDV/SOF and SOF/VEL studies (SOLAR-1, SOLAR-2, ASTRAL-4, N = 463)
  • Comparison with the expected incidence in un-treated patients (survival model from liver transplant waitlist in the pre-DAA era: 2 cohorts, one for model development, one for model validation)

Observed versus expected deaths in DAA-treated patients

  • 54 deaths expected from survival mode
  • 25 deaths observed over 1 year

Standardized mortality ratio

Observed versus expected deaths in DAA-treated patients
Observed deaths from W12 vs expected re-calculated from W12 data update


  • Decompensated HCV cirrhosis patients treated with LDV/SOF or SOF/VEL experienced significantly fewer deaths than predicted by the survival model
    • The difference became significant in less than 120 days
    • By the end of the first year, the risk was reduced by 54%
  • When the survival model was re-applied with week 12 updated data, observed and expected mortality matched, suggesting
    • Re-compensation following DAA therapy
    • SVR on DAA therapy translates in mortality benefit
    • A further validation of the survival model