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Viral eradication reduces all‐cause mortality in patients with chronic hepatitis C virus infection: a propensity score analysis
Author(s) -
Tada Toshifumi,
Kumada Takashi,
Toyoda Hidenori,
Kiriyama Seiki,
Tanikawa Makoto,
Hisanaga Yasuhiro,
Kanamori Akira,
Kitabatake Shusuke,
Yama Tsuyoki,
Tanaka Junko
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13071
Subject(s) - medicine , propensity score matching , virology , virus , chronic hepatitis , hepatitis a virus
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 .