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

Observed versus expected deaths in DAA-treated patients Survival benefits of DAA in patients with decompensated cirrhosis Observed versus expected deaths in DAA-treated patients 50 100 150 200 250 300 350 10 20 30 40 60 70 p < 0.05 SMR = 0.46 Days from treatment initiation Expected Observed 54 25 54 deaths expected from survival mode 25 deaths observed over 1 year Standardized mortality ratio Survival Decompensated Cirrhosis Kim WR, EASL 2018, Abs. PS-151

Observed versus expected deaths in DAA-treated patients Survival benefits of DAA in patients with decompensated cirrhosis Observed versus expected deaths in DAA-treated patients Observed deaths from W12 vs expected re-calculated from W12 data update 50 100 150 200 250 300 350 10 20 30 40 60 70 p = NS Days from treatment initiation W12 Expected Observed Survival Decompensated Cirrhosis Kim WR, EASL 2018, Abs. PS-151

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