Bibliographic Details
| Title: |
Improved Survival Among all Interferon-α-Treated Patients in HCV-002, a Veterans Affairs Hepatitis C Cohort of 2211 Patients, Despite Increased Cirrhosis Among Nonresponders. |
| Authors: |
Cozen, Myrna, Ryan, James, Shen, Hui, Cheung, Ramsey, Kaplan, David, Pocha, Christine, Brau, Norbert, Aytaman, Ayse, Schmidt, Warren, Pedrosa, Marcos, Anand, Bhupinderjit, Chang, Kyong-Mi, Morgan, Timothy, Monto, Alexander, Cozen, Myrna L, Ryan, James C, Kaplan, David E, Schmidt, Warren N, Anand, Bhupinderjit S |
| Source: |
Digestive Diseases & Sciences; Jun2016, Vol. 61 Issue 6, p1744-1756, 13p |
| Subject Terms: |
INTERFERON alpha, HEPATITIS C treatment, HEPATITIS C, CIRRHOSIS of the liver, COHORT analysis, PATIENTS, THERAPEUTICS, THERAPEUTIC use of proteins, LONGITUDINAL method, PROTEINS, RESEARCH funding, RIBAVIRIN, PROPORTIONAL hazards models |
| Geographic Terms: |
UNITED States |
| Company/Entity: |
UNITED States. Dept. of Veterans Affairs |
| Abstract: |
Background: As the era of interferon-alpha (IFN)-based therapy for hepatitis C ends, long-term treatment outcomes are now being evaluated.Aim: To more fully understand the natural history of hepatitis C infection by following a multisite cohort of patients.Methods: Patients with chronic HCV were prospectively enrolled in 1999-2000 from 11 VA medical centers and followed through retrospective medical record review.Results: A total of 2211 patients were followed for an average of 8.5 years after enrollment. Thirty-one percent of patients received HCV antiviral therapy, 15 % with standard IFN/ribavirin only, 16 % with pegylated IFN/ribavirin, and 26.7 % of treated patients achieved sustained virologic response (SVR). Cirrhosis developed in 25.8 % of patients. Treatment nonresponders had a greater than twofold increase in the hazard of cirrhosis and hepatocellular carcinoma, compared to untreated patients, whereas SVR patients were only marginally protected from cirrhosis. Nearly 6 % developed hepatocellular carcinoma, and 27.1 % died during the follow-up period. Treated patients, regardless of response, had a significant survival benefit compared to untreated patients (HR 0.58, CI 0.46-0.72). Improved survival was also associated with college education, younger age, lower levels of alcohol consumption, and longer duration of medical service follow-up-factors typically associated with treatment eligibility.Conclusions: As more hepatitis C patients are now being assessed for all-oral combination therapy, these results highlight that patient compliance and limiting harmful behaviors contribute a significant proportion of the survival benefit in treated patients and that the long-term clinical benefits of SVR may be less profound than previously reported. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
