Long-term prognosis of patients with chronic hepatitis C who did not receive interferon-based therapy: causes of death and analysis based on the FIB-4 index
Autor: | Hidenori Toyoda, Akira Kanamori, Takashi Kumada, Junko Tanaka, Shusuke Kitabatake, Yasuhiro Hisanaga, Makoto Tanikawa, Seiki Kiriyama, Toshifumi Tada, Tsuyoki Yama |
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Rok vydání: | 2015 |
Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Multivariate analysis Gastroenterology 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Cause of Death medicine Humans Risk factor Aged Retrospective Studies business.industry Mortality rate Liver Diseases Hazard ratio Hepatitis C Hepatology Hepatitis C Chronic Middle Aged medicine.disease Prognosis Survival Analysis Confidence interval 030220 oncology & carcinogenesis Immunology Multivariate Analysis 030211 gastroenterology & hepatology Female business Abdominal surgery Follow-Up Studies |
Zdroj: | Journal of gastroenterology. 51(4) |
ISSN: | 1435-5922 |
Popis: | Interferon (IFN)-based therapy has been reported to reduce the liver-related mortality rate in patients with chronic hepatitis C virus (HCV) infection. However, predictors of survival and causes of death, including non-liver-related causes, have not been sufficiently investigated in chronic HCV patients who have not received IFN-based therapy.A total of 1723 patients with chronic HCV infection who were not treated with IFN-based therapy were enrolled. Survival from liver-related diseases and non-liver-related diseases and causes of death were analyzed on the basis of the fibrosis-4 (FIB-4) index, an index of liver fibrosis.The median follow-up duration was 10.3 years. Of 465 patients who died during the follow-up period, 48.4 % died of liver-related diseases; of the remainder, 51.6 % died of non-liver-related diseases. On the basis of FIB-4 index, the liver-related mortality rate increased as the FIB-4 index increased: 16.1 % in the FIB-4 index1.45 group, 36.7 % in the 1.45 ≤ FIB-4 index ≤ 3.25 group, and 58.7 % in the FIB-4 index3.25 group (p0.001). Conversely, the non-liver-related mortality rate decreased as the FIB-4 index increased: 83.9, 63.3, and 41.3 %, respectively (p = 0.001). In the multivariate analysis, a FIB-4 index greater than 3.25 was identified as a risk factor independently associated with both liver-related death (hazard ratio 13.020; 95 % confidence interval 4.155-40.770) and non-liver-related death (hazard ratio 1.667; 95 % confidence interval 1.188-2.340).Patients with chronic HCV infection and an elevated FIB-4 index may benefit from monitoring not only for the development of liver-related diseases but also for the development of non-liver-related diseases. |
Databáze: | OpenAIRE |
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