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Effectiveness of combination therapy of splenectomy and long‐term interferon in patients with hepatitis C virus‐related cirrhosis and thrombocytopenia
Author(s) -
Morihara Daisuke,
Kobayashi Masahiro,
Ikeda Kenji,
Kawamura Yusuke,
Saneto Hiromi,
Yatuji Hiromi,
Hosaka Tetuya,
Sezaki Hitomi,
Akuta Norio,
Suzuki Yoshiyuki,
Suzuki Fumitaka,
Kumada Hiromitu
Publication year - 2009
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2008.00481.x
Subject(s) - splenectomy , medicine , cirrhosis , gastroenterology , hepatitis c virus , combination therapy , interferon , hepatitis c , complete response , surgery , virus , immunology , chemotherapy , spleen
Aim: To elucidate the effectiveness of combination therapy of splenectomy and long‐term interferon (IFN) on survival and hepatocarcinogenesis, we retrospectively analyzed 180 patients with hepatitis C virus (HCV)‐related cirrhosis and thrombocytopenia. Methods: Group A consisted of 121 patients who received neither splenectomy nor IFN therapy. Group B consisted of 11 patients who underwent splenectomy only. Group C consisted of 32 patients who underwent IFN therapy only. Group D consisted of 16 patients who received the combination therapy splenectomy followed by IFN therapy. Results: The viral response in group D estimated at least 6 months after IFN therapy showed sustained viral response in four patients, biochemical response in one and no response in six. Multivariate analysis using time‐dependent variables showed significant improvement of survival rate in patients on the combination therapy,but no effect on the appearance rate of hepatocarcinogenesis relative to the findings in group A. Conclusions: In this study, the splenectomy did not directly improve the prognosis, but increased the ability for patients to undergo IFN. As a result, we considered that the combination therapy of splenectomy and long‐term IFN significantly improved survival rate in patients with advanced HCV‐related cirrhosis and thrombocytopenia.