Effects and outcomes of interferon treatment in Japanese hepatitis C patients

BMC Gastroenterol. 2012 Oct 12;12:139. doi: 10.1186/1471-230X-12-139.

Abstract

Background: No study has compared the long-term prognoses of hepatitis C patients with hepatitis C virus (HCV) antibody-negative individuals and investigated the effects of interferon (IFN) treatment. To clarify the long-term prognosis of HCV-positive residents of an isolated Japanese island and prospectively investigate the effects of IFN treatment in comparison with the HCV-negative general population.

Methods: HCV antibody was positive in 1,343 (7.6%) of the 17,712 individuals screened. 792 HCV RNA-positive, HBsAg-negative subjects were enrolled. 1,584 HCV antibody-negative, HBsAg-negative general residents were sex- and age-matched to the 792 subjects. A total of 154 <70-year-old patients without liver cirrhosis (LC) or hepatocellular carcinoma (HCC) underwent IFN treatment. The survival rate with all-cause death as the endpoint was determined and causes of death were compared.

Results: The 10- and 20-year survival rates of the hepatitis C and general resident groups were 65.4% and 87.8%, and 40.8% and 62.5%, respectively (p < 0.001; hazard risk ratio, 0.444; 95% confidence interval (CI): 0.389-0.507). There were 167 liver disease-related deaths and 223 deaths from other causes in the hepatitis C group, and 7 and 451, respectively, in the general resident group. Liver disease-related death accounted for 43.8% and 1.5% of deaths in the hepatitis C and general resident groups (p < 0.0001). The cumulative survival rate of the hepatitis C patients without IFN (n = 328) was significantly lower than the gender- and age-matched general resident group (n = 656) (p < 0.0001) but there was no significant difference between the IFN-treated (n = 154) and general resident groups (n = 308).

Conclusions: In the hepatitis C group, the proportion of liver disease-related death was markedly higher, and the survival rate lower, than the general resident group. Introduction of IFN treatment in <70-year-old patients with hepatitis C without LC or HCC improved the survival rate to a level comparable to that of the general residents.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiviral Agents / therapeutic use*
  • Asian Continental Ancestry Group*
  • Cause of Death
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • Hepatitis C / blood
  • Hepatitis C / drug therapy*
  • Hepatitis C / immunology
  • Hepatitis C / mortality
  • Hepatitis C Antibodies / blood
  • Hepatitis C Antibodies / immunology
  • Humans
  • Interferon-alpha / therapeutic use*
  • Interferon-beta / therapeutic use*
  • Life Expectancy
  • Male
  • Middle Aged
  • Prognosis
  • Ribavirin / therapeutic use
  • Survival Rate
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Hepatitis C Antibodies
  • Interferon-alpha
  • Ribavirin
  • Interferon-beta