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Hepatitis C treatment failure is associated with increased risk of hepatocellular carcinoma.

Authors :
Lu M
Li J
Rupp LB
Holmberg SD
Moorman AC
Spradling PR
Teshale EH
Zhou Y
Boscarino JA
Schmidt MA
Lamerato LE
Trinacty C
Trudeau S
Gordon SC
Source :
Journal of viral hepatitis [J Viral Hepat] 2016 Sep; Vol. 23 (9), pp. 718-29. Date of Electronic Publication: 2016 Mar 30.
Publication Year :
2016

Abstract

Sustained virological response (SVR) to antiviral therapy for hepatitis C (HCV) reduces risk of hepatocellular carcinoma (HCC), but there is little information regarding how treatment failure (TF) compares to lack of treatment. We evaluated the impact of treatment status on risk of HCC using data from the Chronic Hepatitis Cohort Study (CHeCS-an observational study based in four large US health systems, with up to 7 years of follow-up on patients). Multivariable analyses were used to adjust for bias in treatment selection, as well as other covariates, followed by sensitivity analyses. Among 10 091 HCV patients, 3681 (36%) received treatment, 2099 (57%) experienced treatment failure (TF), and 1582 (43%) of these achieved sustained virological response (SVR). TF patients demonstrated almost twice the risk of HCC than untreated patients [adjusted hazard ratio (aHR) = 1.95, 95% confidence interval (CI) 1.50-2.53]; this risk persisted across all stages of fibrosis. Several sensitivity analyses validated these results. Although African Americans were at increased risk of treatment failure, they were at lower risk for HCC and all-cause mortality compared to White patients. SVR patients had lower risk of HCC than TF patients (aHR = 0.48, CI 0.31-0.73), whereas treatment - regardless of outcome - reduced all-cause mortality (aHR = 0.45, CI 0.34-0.60 for SVR patients; aHR = 0.78, CI 0.65-0.93 for TF patients).<br /> (© 2016 John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1365-2893
Volume :
23
Issue :
9
Database :
MEDLINE
Journal :
Journal of viral hepatitis
Publication Type :
Academic Journal
Accession number :
27028626
Full Text :
https://doi.org/10.1111/jvh.12538