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- Title
Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C.
- Authors
Martínez-Macías, Roberto F.; Cordero-Pérez, Paula; Juérez-Rodríguez, Omar A.; Chen-López, Carlos Y.; Martínez-Carrillo, Francisco M.; Alarcón-Galván, Gabriela; Mercado-Hernández, Roberto; Muñoz-Espinosa, Linda E.
- Abstract
Background. We compared mortality and complications of chronic hepatitis C between treated and untreated Mexican patients after long-term follow-up. We used a time-to-event analysis and identified the prognostic factors. Material and methods. Seventy-four patients with chronic hepatitis C were studied. They were ⩾ 18 years of age and had a molecular diagnosis of chronic hepatitis C and ⩾ 6 months of follow- up. Patients with neoplasia or those infected with human immunodeficiency virus or hepatitis B Virus were excluded. Kaplan-Meier analysis, log-rank test, annualized incidence per 100 person-years, and stepwise discriminant analysis were used to analyse mortality and complications. Results. The end-point of annualized incidence was lowest in sustained virological responders, intermediate in non-responders, and highest in untreated patients. The absence of treatment impacted adversely on cirrhosis development and the occurrence of portal hypertension and hepatic decompensation/hepatocellular carcinoma (logrank, p < 0.05). Diabetes impacted adversely on liver-related death/liver transplantation among untreated patients. Stepwise discriminant analysis showed that diabetes, high blood pressure, and no retreatment predicted cirrhosis development (eigenvalue ⩾ 0.8; p < 0.05). A MELD score ⩾ 18 and age ⩾ 50 years predicted hepatic decompensation/hepatocellular carcinoma (eigenvalue < 0.8; p < 0.05). APRI ⩾ 1.5 predicted mortality/liver transplantation and liver-related death/liver transplantation (eigenvalue < 0.8; p < 0.05). Conclusions. This is the first long-term study of chronic hepatitis C among Mexican patients. Treated patients showed less progression of liver disease. Treated patients showed less progression of liver disease; and older patients, those with metabolic comorbidities, with MELD score ⩾ 18 and APRI ⩾ 1.5 exhibited adverse effects.
- Subjects
CHRONIC hepatitis C; INTERFERONS; MORTALITY; SURGICAL complications; KAPLAN-Meier estimator; DISCRIMINANT analysis; CIRRHOSIS of the liver; LIVER cancer; THERAPEUTICS
- Publication
Annals of Hepatology: Official Journal of the Mexican Association of Hepatology, 2015, Vol 14, Issue 1, p36
- ISSN
1665-2681
- Publication type
Article
- DOI
10.1016/s1665-2681(19)30799-9