Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients
Journal
PLoS ONE
Journal Volume
8
Journal Issue
7
Pages
e70458
Date Issued
2013
Author(s)
Abstract
Background:Interferon-based therapy (IBT) has been the standard of care for hepatitis C virus (HCV) infection. However, conflicting results exist regarding the effects of IBT on risk of developing hepatocellular carcinoma (HCC) and cirrhosis-associated complications, and most included highly selected patients.Methods:This 8-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 (>23.7 million). Patients with newly detected HCV infections (n = 11,264) were classified based on treatment and clinical outcomes. IBTs were defined as regimens that included interferon- alfa, pegylated interferon- alfa -2a, or pegylated interferon- alfa -2b for at least 3 months. The Cox proportional hazards models were used to estimate the hazard ratio (HR) and associated confidence interval (CI) of HCC and cirrhosis-associated complications for IBT.Results:The 8-year incidence rate for HCC was 3.9% among patients who received IBT and 5.6% among those who did not. The HCC-free survival rate was significantly higher among patients receiving IBT during the 8-year period than their counterpart (adjusted HR, 0.50; 95% CI, 0.31-0.81; P =. 004). Similarly, the event-free survival rates for esophageal variceal bleeding (adjusted HR, 0.45; 95% CI, 0.22-0.91; P =. 026), hepatic encephalopathy (adjusted HR, 0.38; 95% CI, 0.21-0.69; P =. 001), ascites (adjusted HR, 0.28; 95% CI, 0.14-0.57; P<.001), and cirrhosis (adjusted HR, 0.63; 95% CI, 0.44-0.91; P =. 013) were significantly higher among patients who received IBT than those who did not, after adjustment for associated factors.Conclusion:Treatment with interferon may reduce the 8-year risk of HCC and cirrhosis-associated complications in patients with chronic HCV infection. ? 2013 Hsu et al.
SDGs
Other Subjects
alpha interferon; peginterferon alpha2a; peginterferon alpha2b; recombinant interferon; adult; aged; article; ascites; cancer risk; cohort analysis; controlled study; disease association; disease free survival; esophagus varices bleeding; event free survival; female; health insurance; hepatic encephalopathy; hepatitis C; human; immunotherapy; incidence; interferon based therapy; liver cell carcinoma; liver cirrhosis; major clinical study; male; patient coding; risk assessment; risk reduction; Taiwan; treatment outcome; virus detection; Aged; Aged, 80 and over; Alzheimer Disease; Animals; Brain Mapping; Case-Control Studies; Cell Physiological Phenomena; Female; Fluorodeoxyglucose F18; Follow-Up Studies; Glucose; Humans; Longitudinal Studies; Male; Mice; Middle Aged; Mild Cognitive Impairment; Neural Networks (Computer); Neuroimaging; Positron-Emission Tomography; Rats
Type
journal article