Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in Mongolia

(1) Background: Hepatitis C virus (HCV) infection poses a significant health burden, particularly in Mongolia, where the HCV prevalence is notably high. This study evaluates the long-term outcomes of HCV treatment with ledipasvir/sofosbuvir, focusing on mortality, viral relapse, and hepatocellular c...

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Main Authors: Amgalan Byambasuren, Buyankhishig Gyarvuulkhasuren, Byambatsogt Erdenebat, Khurelbaatar Nyamdavaa, Oidov Baatarkhuu
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Viruses
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Online Access:https://www.mdpi.com/1999-4915/17/6/743
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author Amgalan Byambasuren
Buyankhishig Gyarvuulkhasuren
Byambatsogt Erdenebat
Khurelbaatar Nyamdavaa
Oidov Baatarkhuu
author_facet Amgalan Byambasuren
Buyankhishig Gyarvuulkhasuren
Byambatsogt Erdenebat
Khurelbaatar Nyamdavaa
Oidov Baatarkhuu
author_sort Amgalan Byambasuren
collection DOAJ
description (1) Background: Hepatitis C virus (HCV) infection poses a significant health burden, particularly in Mongolia, where the HCV prevalence is notably high. This study evaluates the long-term outcomes of HCV treatment with ledipasvir/sofosbuvir, focusing on mortality, viral relapse, and hepatocellular carcinoma (HCC) development. (2) Methods: This prospective, longitudinal cohort study initially enrolled patients with chronic HCV in Mongolia between 2016 and 2017, focusing on those who completed the five-year follow-up (<i>n</i> = 303). The study measured long-term mortality, HCC development, and viral relapse, employing non-invasive methods to assess liver fibrosis and liver function. (3) Results: At the outset, 98.2% of the patients achieved undetectable HCV RNA levels. Over five years, 6.27% experienced viral relapse and 3.30% developed hepatocellular carcinoma (HCC), with a mortality rate of 5.94%. In a multivariable analysis, the significant predictors for HCC occurrence included age (OR = 1.081, 95% CI = 1.021–1.145), liver cirrhosis (OR = 5.866, 95% CI = 1.672–22.577), and GGT level (OR = 1.011, 95% CI = 1.004–1.018). The independent predictors of mortality included age (OR = 1.083, 95% CI = 1.024–1.147), liver cirrhosis (OR = 6.529, 95% CI = 1.913–22.281), and GGT (OR = 1.011, 95% CI = 1.004–1.017). (4) Conclusions: This study demonstrates that ledipasvir/sofosbuvir effectively suppresses HCV initially and maintains low viral relapse rates over the long term. However, it emphasizes the need for continued management to reduce the long-term risk of HCC and mortality, especially in patients with severe liver fibrosis or cirrhosis.
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spelling doaj-art-603d152c72464628ab9675a960e71b9c2025-08-20T03:32:33ZengMDPI AGViruses1999-49152025-05-0117674310.3390/v17060743Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in MongoliaAmgalan Byambasuren0Buyankhishig Gyarvuulkhasuren1Byambatsogt Erdenebat2Khurelbaatar Nyamdavaa3Oidov Baatarkhuu4Department of Health Research, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, MongoliaGeneral Hospital of the Arkhangai Province, Tsetserleg 65191, MongoliaHealth Department of the Arkhangai Province, Tsetserleg 65089, MongoliaDepartment of Physiology, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, MongoliaDepartment of Infectious Diseases, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia(1) Background: Hepatitis C virus (HCV) infection poses a significant health burden, particularly in Mongolia, where the HCV prevalence is notably high. This study evaluates the long-term outcomes of HCV treatment with ledipasvir/sofosbuvir, focusing on mortality, viral relapse, and hepatocellular carcinoma (HCC) development. (2) Methods: This prospective, longitudinal cohort study initially enrolled patients with chronic HCV in Mongolia between 2016 and 2017, focusing on those who completed the five-year follow-up (<i>n</i> = 303). The study measured long-term mortality, HCC development, and viral relapse, employing non-invasive methods to assess liver fibrosis and liver function. (3) Results: At the outset, 98.2% of the patients achieved undetectable HCV RNA levels. Over five years, 6.27% experienced viral relapse and 3.30% developed hepatocellular carcinoma (HCC), with a mortality rate of 5.94%. In a multivariable analysis, the significant predictors for HCC occurrence included age (OR = 1.081, 95% CI = 1.021–1.145), liver cirrhosis (OR = 5.866, 95% CI = 1.672–22.577), and GGT level (OR = 1.011, 95% CI = 1.004–1.018). The independent predictors of mortality included age (OR = 1.083, 95% CI = 1.024–1.147), liver cirrhosis (OR = 6.529, 95% CI = 1.913–22.281), and GGT (OR = 1.011, 95% CI = 1.004–1.017). (4) Conclusions: This study demonstrates that ledipasvir/sofosbuvir effectively suppresses HCV initially and maintains low viral relapse rates over the long term. However, it emphasizes the need for continued management to reduce the long-term risk of HCC and mortality, especially in patients with severe liver fibrosis or cirrhosis.https://www.mdpi.com/1999-4915/17/6/743viral suppressionliver cirrhosischronic liver diseaseantiviral therapy
spellingShingle Amgalan Byambasuren
Buyankhishig Gyarvuulkhasuren
Byambatsogt Erdenebat
Khurelbaatar Nyamdavaa
Oidov Baatarkhuu
Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in Mongolia
Viruses
viral suppression
liver cirrhosis
chronic liver disease
antiviral therapy
title Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in Mongolia
title_full Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in Mongolia
title_fullStr Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in Mongolia
title_full_unstemmed Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in Mongolia
title_short Long-Term Outcomes of Ledipasvir/Sofosbuvir Treatment in Hepatitis C: Viral Suppression, Hepatocellular Carcinoma, and Mortality in Mongolia
title_sort long term outcomes of ledipasvir sofosbuvir treatment in hepatitis c viral suppression hepatocellular carcinoma and mortality in mongolia
topic viral suppression
liver cirrhosis
chronic liver disease
antiviral therapy
url https://www.mdpi.com/1999-4915/17/6/743
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