Early antiviral therapy reduces the risk of lymphoma in patients with chronic hepatitis C infection
Journal
Alimentary Pharmacology and Therapeutics
Journal Volume
49
Journal Issue
3
Pages
331-339
Date Issued
2019
Abstract
Background: Chronic hepatitis C infection is linked to lymphoma development. Aim: To investigate whether antiviral therapy prevents the risk of HCV-related lymphoma. Methods: Patients diagnosed with chronic hepatitis C were retrieved from the Taiwan National Health Insurance Research Database during 2004-2012. We included patients who received pegylated interferon and ribavirin (PegIFN/RBV) antiviral therapy for ?24?weeks (PegIFN/RBV cohort) or hepatoprotectants for ?90?days without antiviral therapy (HCV-untreated cohort). Both cohorts were matched by age, sex, and comorbidities through propensity scores and followed for newly diagnosed lymphoma or non-Hodgkin's lymphoma (NHL). Results: In total, 24?133 patients were included in both the PegIFN/RBV and HCV-untreated cohort. The lymphoma incidence was significantly higher in the untreated than in the treated cohort (66.48 vs 43.34 per 100?000 person-years, P?=?0.029). After adjusting for confounders, the patients who received PegIFN/RBV therapy were at a lower risk of developing lymphoma compared with the untreated patients (hazard ratio [HR]: 0.64, 95% confidence interval [CI]: 0.43-0.96, P?=?0.030). Moreover, this beneficial effect was mainly observed in patients with chronic hepatitis C <60?years old with a relative risk reduction of 51% for all lymphoma (HR: 0.49, 95% CI: 0.29-0.82, P?=?0.007) and 48% for non-Hodgkin's lymphoma (HR: 0.52, 95% CI: 0.30-0.91, P?=?0.022). The risk of all lymphoma or non-Hodgkin's lymphoma development after antiviral therapy was lowered to that of subjects without HCV. Conclusions: PegIFN/RBV-based antiviral therapy significantly reduced the risk of lymphoma, especially non-Hodgkin's lymphoma; the reduction was mostly among patients <60?years old. Early antiviral therapy for chronic hepatitis C is suggested. ? 2018 John Wiley & Sons Ltd
SDGs
Other Subjects
peginterferon; ribavirin; alpha interferon; antivirus agent; macrogol; ribavirin; adult; age distribution; antiviral therapy; Article; cancer incidence; cancer risk; chronic hepatitis C; cohort analysis; combination drug therapy; comorbidity; confidence interval; controlled study; data base; female; follow up; hazard ratio; human; lymphoma; major clinical study; male; medical research; national health insurance; nonhodgkin lymphoma; population research; priority journal; propensity score; risk reduction; sex difference; Taiwan; time to treatment; treatment duration; chemistry; chronic hepatitis C; incidence; lymphoma; middle aged; Adult; Antiviral Agents; Cohort Studies; Drug Therapy, Combination; Female; Hepatitis C, Chronic; Humans; Incidence; Interferon-alpha; Lymphoma; Male; Middle Aged; Polyethylene Glycols; Ribavirin; Taiwan
Publisher
Blackwell Publishing Ltd
Type
journal article