Viral eradication reduces all‐cause mortality in patients with chronic hepatitis C virus infection: a propensity score analysis. (12th February 2016)

• Record Type: Journal Article
• Authors: Tada, Toshifumi; Kumada, Takashi; Toyoda, Hidenori; Kiriyama, Seiki; Tanikawa, Makoto; Hisanaga, Yasuhiro; Kanamori, Akira; Kitabatake, Shusuke; Yama, Tsuyoki; Tanaka, Junko
• Is Part Of: Liver international. Volume 36:Number 6(2016)
• Page Start: 817
• Page End: 826
• Publication Date: 2016-02-12
• Subjects: causes of death -- eradication of HCV -- hepatitis C -- non–liver‐related mortality -- survival; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.13071
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: 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. Abstract : See Editorial on Page794