https://scholars.lib.ntu.edu.tw/handle/123456789/537624
標題: | Early antiviral therapy reduces the risk of lymphoma in patients with chronic hepatitis C infection | 作者: | TUNG-HUNG SU CHUN-JEN LIU TAI-CHUNG TSENG Chou S.-W CHEN-HUA LIU HUNG-CHIH YANG SHANG-JU WU PEI-JER CHEN DING-SHINN CHEN CHI-LING CHEN JIA-HORNG KAO |
公開日期: | 2019 | 出版社: | Blackwell Publishing Ltd | 卷: | 49 | 期: | 3 | 起(迄)頁: | 331-339 | 來源出版物: | Alimentary Pharmacology and Therapeutics | 摘要: | 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 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85059159956&doi=10.1111%2fapt.15101&partnerID=40&md5=3edc03192c74f79f69bb031c7e905285 https://scholars.lib.ntu.edu.tw/handle/123456789/537624 |
ISSN: | 0269-2813 | DOI: | 10.1111/apt.15101 | SDG/關鍵字: | 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 |
顯示於: | 醫學系 |
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