6533b7d8fe1ef96bd126a50a
RESEARCH PRODUCT
Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study
Bruno SStroffolini TColombo MBollani SBenvegnu LMazzella GAscione ASantantonio TPiccinino FAndreone PMangia AGaeta GbPersico MFagiuoli SPier Luigi AlmasioItalian Association Of The Study Of The Liver Disease Aisfsubject
Liver CirrhosisMaleANTIVIRAL TREATMENTMultivariate analysisCirrhosisHepacivirusdrug therapy/mortality/virologyGastroenterologyCohort StudiesINTERFERON; HEPATITIS C; CIRRHOSIS; CHRONIC HEPATITIS C; ANTIVIRAL TREATMENT; SUSTAINED VIROLOGICAL RESPONSE; Liver cirrhosis.MedicinegeneticsLongitudinal StudiesViralCIRRHOSISHazard ratiovirus diseasesHepatitis CAdult Antiviral Agents; therapeutic use Cohort Studies Female Hepacivirus; genetics Hepatitis C; blood/complications/drug therapy/mortality Humans Interferon-alpha; therapeutic use Liver Cirrhosis; drug therapy/mortality/virology Longitudinal Studies Male Middle Aged Multivariate Analysis RNA; Viral; blood Retrospective Studies Survival Analysis Treatment OutcomeMiddle AgedLiver cirrhosis.Treatment OutcomeSUSTAINED VIROLOGICAL RESPONSEHEPATITIS CLiver Cirrhosis/drug therapy Liver Cirrhosis/virologyRNA ViralFemaleAdultINTERFERONmedicine.medical_specialtyCHRONIC HEPATITIS CAntiviral AgentsbloodInternal medicineHumansRetrospective StudiesSustained virological response interferon-alpha HCV-related cirrhosis:Hepatologybusiness.industryProportional hazards modelInterferon-alphaRetrospective cohort studyblood/complications/drug therapy/mortalityHepatologymedicine.diseaseSurvival Analysisdigestive system diseasesDiscontinuationSurgerytherapeutic useMultivariate AnalysisRNAbusinessdescription
The effect of achieving a sustained virological response (SVR) following interferon-α (IFNα) treatment on the clinical outcomes of patients with HCV-related cirrhosis is unknown. In an attempt to assess the risk of liver-related complications, HCC and liver-related mortality in patients with cirrhosis according to the response to IFNα treatment, a retrospective database was developed including all consecutive patients with HCV-related, histologically proven cirrhosis treated with IFNα monotherapy between January 1992 and December 1997. SVR was an undetectable serum HCV-RNA by PCR 24 weeks after IFNα discontinuation. HCC was assessed by ultrasound every 6 months. Independent predictors of all outcomes were assessed by Cox regression analysis. Of 920 patients, 124 (13.5%) were classified as achieving a SVR. During a mean follow-up of 96.1 months (range: 6-167) the incidence rates per 100 person-years of liver-related complications, HCC and liver-related death were 0, 0.66, and 0.19 among SVR and 1.88, 2.10, and 1.44 among non-SVR (P < 0.001 by log-rank test). Multivariate analyses found that non-SVR was associated with a higher risk of liver-related complications (hazard ratio, HR, not applicable), HCC (HR 2.59; 95% CI 1.13-5.97) and liver-related mortality (HR 6.97; 95% CI 1.71-28.42) as compared to SVR. Conclusion: Thus, in patients with HCV-related, histologically proven cirrhosis, achievement of a SVR after IFNα therapy was associated with a reduction of liver-related mortality lowering both the risk of complications and HCC development. Irrespective of SVR achievement, all patients should continue surveillance because the risk of occurrence of HCC was not entirely avoided. (HEPATOLOGY 2007;45:579–587.)
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2007-02-28 |