Viral eradication reduces all-cause mortality, including non-liver-related disease, in patients with progressive hepatitis C virus-related fibrosis
| Autor: | Shusuke Kitabatake, Seiki Kiriyama, Yasuhiro Hisanaga, Junko Tanaka, Akira Kanamori, Makoto Tanikawa, Takashi Kumada, Tsuyoki Yama, Toshifumi Tada, Hidenori Toyoda |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry Hepatitis C virus Incidence (epidemiology) Mortality rate Hazard ratio Gastroenterology virus diseases Hepatitis C medicine.disease medicine.disease_cause Virology digestive system diseases 03 medical and health sciences 0302 clinical medicine Fibrosis 030220 oncology & carcinogenesis Internal medicine Hepatocellular carcinoma medicine 030211 gastroenterology & hepatology business Cause of death |
| Zdroj: | Journal of Gastroenterology and Hepatology. 32:687-694 |
| ISSN: | 0815-9319 |
| Popis: | Background and Aim Eradication of hepatitis C virus (HCV) with interferon (IFN)-based therapy has been reported to reduce all-cause mortality in patients with chronic HCV infection. However, the impact of HCV eradication on non–liver-related mortality and causes of death has not been sufficiently investigated in patients with progressive HCV-related fibrosis. Methods We enrolled 784 chronic HCV patients with progressive liver fibrosis (aspartate aminotransferase to platelet ratio index >1). Cause of death, incidence of hepatocellular carcinoma, and all-cause mortality including non–liver-related mortality were analyzed. Results Of these 784 patients, 170 achieved sustained virological response (SVR) (eradication of HCV) with IFN-based therapy (IFN-SVR), and 614 did not receive IFN-based therapy (non-IFN patients, chronic HCV infection). The median follow-up duration was 10.3 years. Two hundred seventy-three patients died during follow-up (liver-related death, n = 171; non–liver-related death, n = 102). The mortality rate from non–liver-related disease was 63.6% (7/11) in IFN-SVR patients and 36.3% (95/262) in non-IFN patients, respectively. In multivariate analysis, the eradication of HCV associated with not only hepatocellular carcinoma incidence (hazard ratio (HR), 0.162; 95% confidence interval (CI), 0.092–0.284), and all-cause mortality (HR, 0.094; 95% CI, 0.047–0.187), but non–liver-related mortality (HR, 0.286; 95% CI, 0.127–0.644) as well. Conclusions Eradication of HCV reduced both liver-related and non–liver-related mortality in patients with progressive HCV-related fibrosis. |
| Databáze: | OpenAIRE |
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