Viral Eradication reduces all-Cause Mortality, Including non-Liver-Related Disease, in Patients With Progressive Hepatitis C Virus-Related Fibrosis.
2017
Background and Aim
Eradication of hepatitis C virus (HCV) with interferon (IFN)-based therapy has been reported to reduce all-cause mortality in patients with chronic HCV infection. However, the impact of HCV eradication on non–liver-related mortality and causes of death has not been sufficiently investigated in patients with progressive HCV-related fibrosis.
Methods
We enrolled 784 chronic HCV patients with progressive liver fibrosis (aspartate aminotransferase to platelet ratio index >1). Cause of death, incidence of hepatocellular carcinoma, and all-cause mortality including non–liver-related mortality were analyzed.
Results
Of these 784 patients, 170 achieved sustained virological response (SVR) (eradication of HCV) with IFN-based therapy (IFN-SVR), and 614 did not receive IFN-based therapy (non-IFN patients, chronic HCV infection). The median follow-up duration was 10.3 years. Two hundred seventy-three patients died during follow-up (liver-related death, n = 171; non–liver-related death, n = 102). The mortality rate from non–liver-related disease was 63.6% (7/11) in IFN-SVR patients and 36.3% (95/262) in non-IFN patients, respectively. In multivariate analysis, the eradication of HCV associated with not only hepatocellular carcinoma incidence (hazard ratio (HR), 0.162; 95% confidence interval (CI), 0.092–0.284), and all-cause mortality (HR, 0.094; 95% CI, 0.047–0.187), but non–liver-related mortality (HR, 0.286; 95% CI, 0.127–0.644) as well.
Conclusions
Eradication of HCV reduced both liver-related and non–liver-related mortality in patients with progressive HCV-related fibrosis.
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