Clinical course of hepatitis C virus during the first decade of infection: cohort study

Harris, Helen; Ramsay, Mary; Andrews, Nick; Eldridge, K. P.

doi:10.1136/bmj.324.7335.450

Cited by 95 publications

(84 citation statements)

References 24 publications

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“…The proportion of patients with blood products as the principal risk factor was higher than observed in general populations, 86 and may reflect the study's sampling strategy. The relatively low proportion of IVDU may be because patients in this group are less likely to attend follow-up appointments to have a liver biopsy.…”

Section: Patient Characteristicsmentioning

confidence: 80%

“…There is evidence to suggest that cases with hepatitis C are generally at similar risk of all-cause death as the general population. 86 Even though certain subgroups of the hepatitis C population (e.g. those who are involved in active IVDU) are at higher risk of all-cause death, these cases were excluded from the mild hepatitis C trial, and indeed from treatment in general, and are not relevant for the model.…”

Section: All-cause Death Ratesmentioning

confidence: 99%

See 1 more Smart Citation

Health benefits of antiviral therapy for mild chronic hepatitis C: randomised controlled trial and economic evaluation

Wright¹,

Grieve²,

Roberts³

et al. 2006

Health Technol Assess

218

198

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Section: Patient Characteristicsmentioning

confidence: 80%

Section: All-cause Death Ratesmentioning

confidence: 99%

Health benefits of antiviral therapy for mild chronic hepatitis C: randomised controlled trial and economic evaluation

Wright¹,

Grieve²,

Roberts³

et al. 2006

Health Technol Assess

218

198

View full text Add to dashboard Cite

show abstract

“…Indeed, both resolved patients of the current study rapidly declined ALT levels without any fluctuations, while persistently infected subjects demonstrated constantly elevated liver enzymes with experiencing periods of fluctuating ALT or temporal ALT normalization throughout the study. It should be underlined, however, that serum ALT levels may be extremely diverse in acute hepatitis C and that ALT normalization after acute phase is not a reliable marker of recovery as there are patients who remain viremic despite complete and persistent normalization of ALT (2)(3)(4)(5)14). The mechanisms responsible for the broad clinical spectrum of disease presentations are unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The problem is that acute hepatitis C is often clinically mild or completely asymptomatic and is rarely recognized outside prospective surveillance after exposure to known risk factors (14,15). Thus today, predominantly symptomatic cases are diagnosed, which comprise approximately one-third of acute HCV patients (2,16).…”

Section: Introductionmentioning

confidence: 99%

Viral clearance or persistence after acute hepatitis C infection: Interim results from a prospective study

et al. 2008

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“…Some studies have shown a significant increase in mortality in HCV-infected persons, 7,8 whereas others have shown relatively low mortality rate and liver disease progression in otherwise healthy persons. 9,10 In subsets of patients who have undergone liver transplantation, who have human immunodeficiency virus coinfection, or those on hemodialysis, HCV is associated with significantly shortened survival. [11][12][13][14][15][16] Treatment for chronic HCV has been found to be cost-effective 17 and is associated with sustained viral clearance in approximately 54% to 63% of patients overall.…”

mentioning

confidence: 99%

Effect of hepatitis C virus and its treatment on survival†‡

Butt

Moore

2009

Hepatology

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The effect of hepatitis C virus (HCV) and its treatment on survival is not well defined. We undertook this study to determine the effect of HCV and its treatment on survival in a national cohort of HCV-infected veterans and uninfected controls. We used a national sample of HCV-infected persons and HCV-uninfected controls from the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES) to compare survival between the two groups. We also compared the effect of treatment and treatment duration on survival in the HCV-infected group. We used matched Cox proportional hazards model to determine the predictors of mortality. Kaplan-Meier survival plots were generated to determine and compare survival among HCV-infected and HCV-uninfected persons, and among treated and untreated HCV-infected persons. We identified 34,480 matched pairs of HCV-infected subjects and controls. HCV infection was independently associated with a higher risk of mortality (hazards ratio, 1.37; 95% confidence interval, 1.31-1.47). Subjects treated for 48 weeks or longer had the lowest mortality among HCV-infected subjects (hazards ratio, 0.41; 95% confidence interval, 0.27-0.64), whereas those who received less than 48 week of treatment had intermediate mortality ( I t is estimated that more than 170 million persons are infected with the hepatitis C virus (HCV) worldwide. 1 HCV infection is a leading cause of liver cirrhosis, end-stage liver disease, hepatocellular carcinoma, and liver transplantation. 2,3 Treatment for HCV is associated with a reduced risk of liver disease progression and a lower incidence of hepatocellular carcinoma, even when the treatment does not achieve viral eradication. [4][5][6] The impact of HCV infection on survival in the general population is controversial. Some studies have shown a significant increase in mortality in HCV-infected persons, 7,8 whereas others have shown relatively low mortality rate and liver disease progression in otherwise healthy persons. 9,10 In subsets of patients who have undergone liver transplantation, who have human immunodeficiency virus coinfection, or those on hemodialysis, HCV is associated with significantly shortened survival. [11][12][13][14][15][16] Treatment for chronic HCV has been found to be cost-effective 17 and is associated with sustained viral clearance in approximately 54% to 63% of patients overall. [18][19][20][21] However, the effect of HCV infection itself and its treatment on longterm survival is not well known. We used a large national electronically retrieved cohort of HCV infected veterans (ERCHIVES) to compare survival between HCV-infected and HCV-uninfected subjects and to determine the effect of HCV treatment on survival within the HCVinfected subjects. Our study does not attempt to define or determine the appropriateness of treatment initiation,

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Clinical course of hepatitis C virus during the first decade of infection: cohort study

Cited by 95 publications

References 24 publications

Health benefits of antiviral therapy for mild chronic hepatitis C: randomised controlled trial and economic evaluation

Health benefits of antiviral therapy for mild chronic hepatitis C: randomised controlled trial and economic evaluation

Viral clearance or persistence after acute hepatitis C infection: Interim results from a prospective study

Effect of hepatitis C virus and its treatment on survival†‡

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