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Viral eradication reduces all‐cause mortality, including non–liver‐related disease, in patients with progressive hepatitis C virus‐related fibrosis
Author(s) -
Tada Toshifumi,
Kumada Takashi,
Toyoda Hidenori,
Kiriyama Seiki,
Tanikawa Makoto,
Hisanaga Yasuhiro,
Kanamori Akira,
Kitabatake Shusuke,
Yama Tsuyoki,
Tanaka Junko
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13589
Subject(s) - medicine , hepatocellular carcinoma , hazard ratio , hepatitis c virus , gastroenterology , liver disease , hepatitis c , mortality rate , incidence (geometry) , immunology , confidence interval , virus , physics , optics
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.