Viral eradication reduces all-cause mortality in patients with chronic hepatitis C virus infection: a propensity score analysis
Autor: | Takashi Kumada, Junko Tanaka, Toshifumi Tada, Seiki Kiriyama, Tsuyoki Yama, Akira Kanamori, Shusuke Kitabatake, Makoto Tanikawa, Yasuhiro Hisanaga, Hidenori Toyoda |
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Rok vydání: | 2015 |
Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular Sustained Virologic Response Hepatitis C virus Hepacivirus medicine.disease_cause Antiviral Agents 03 medical and health sciences 0302 clinical medicine Japan Internal medicine Cause of Death medicine Humans Mortality Propensity Score Cause of death Aged Proportional Hazards Models Hepatology business.industry Incidence (epidemiology) Mortality rate Incidence Hazard ratio Liver Neoplasms virus diseases Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease digestive system diseases ROC Curve 030220 oncology & carcinogenesis Hepatocellular carcinoma Immunology Cohort 030211 gastroenterology & hepatology Female Interferons business |
Zdroj: | Liver international : official journal of the International Association for the Study of the Liver. 36(6) |
ISSN: | 1478-3231 |
Popis: | Background & Aims Eradication of hepatitis C virus (HCV) by interferon (IFN)-based therapy has been reported to reduce all-cause mortality rates in patients with chronic HCV infection. However, the impact of HCV eradication on non–liver-related mortality including the causes of death has not been sufficiently investigated in patients with chronic HCV infection. Methods We enrolled 2743 patients with chronic HCV infection. Causes of death, incidence of hepatocellular carcinoma (HCC), and all-cause mortality including non–liver-related diseases, were analysed. Results Of these 2743 patients, 587 achieved sustained virological response (SVR) (eradication of HCV) by IFN-based therapy (IFN-SVR), 475 did not (without HCV eradication) (IFN-non-SVR), or 1681 did not receive IFN-based therapy (non-IFN patients) (Cohort 1); of these, 309 were selected from IFN-SVR and non-IFN groups using propensity score matching (Cohort 2).The median follow-up duration was 11.4 years. In Cohort 1 patients, mortality rates from non–liver-related diseases were 71.0% (22/31) in IFN-SVR patients, 34.9% (37/106) in IFN-non-SVR patients and 50.0% (248/496) in non-IFN patients respectively. In Cohort 2 patients, mortality rates from non–liver-related diseases were 72.2% (13/18) in IFN-SVR patients and 46.8% (29/62) in non-IFN patients respectively. The eradication of HCV reduced all-cause mortality (hazard ratio (HR), 0.265; 95% confidence interval (CI), 0.058–0.380) including non–liver-related mortality (HR, 0.439; 95% CI, 0.231–0.834) and the incidence of HCC (HR, 0.275; 95% CI, 0.156–0.448). Conclusions Eradication of HCV reduced not only liver-related mortality but also non–liver-related mortality in patients with chronic HCV. |
Databáze: | OpenAIRE |
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