Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients

Abstract

BackgroundInterferon-based therapy (IBT) has been the standard of care for hepatitis C virus (HCV) infection. However, conflicting results exist regarding the effects of IBT on risk of developing hepatocellular carcinoma (HCC) and cirrhosis-associated complications, and most included highly selected patients.MethodsThis 8-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 (>23.7 million). Patients with newly detected HCV infections (n = 11,264) were classified based on treatment and clinical outcomes. IBTs were defined as regimens that included interferon- alfa, pegylated interferon- alfa -2a, or pegylated interferon- alfa -2b for at least 3 months. The Cox proportional hazards models were used to estimate the hazard ratio (HR) and associated confidence interval (CI) of HCC and cirrhosis-associated complications for IBT.ResultsThe 8-year incidence rate for HCC was 3.9% among patients who received IBT and 5.6% among those who did not. The HCC-free survival rate was significantly higher among patients receiving IBT during the 8-year period than their counterpart (adjusted HR, 0.50; 95% CI, 0.31–0.81; P = .004). Similarly, the event-free survival rates for esophageal variceal bleeding (adjusted HR, 0.45; 95% CI, 0.22–0.91; P = .026), hepatic encephalopathy (adjusted HR, 0.38; 95% CI, 0.21–0.69; P = .001), ascites (adjusted HR, 0.28; 95% CI, 0.14–0.57; P<.001), and cirrhosis (adjusted HR, 0.63; 95% CI, 0.44–0.91; P = .013) were significantly higher among patients who received IBT than those who did not, after adjustment for associated factors.ConclusionTreatment with interferon may reduce the 8-year risk of HCC and cirrhosis-associated complications in patients with chronic HCV infection.

Hepatitis C virus infection increases the risk of developing peripheral arterial disease: A 9-year population-based cohort study

“…Therefore, HCV infection should no longer be considered as a disease concerning hepatologists alone -all physicians should improve their knowledge on HCV infection. Third, recent studies have confirmed that antiviral treatment of HCV infection can improve cardiovascular, renal, and hepatic outcomes in HCV-infected patients [28,29], indicating the potential for more optimistic outcomes of HCVassociated vascular complications. Accordingly, further research is warranted to elucidate the effects of antiviral treatment on PAD.…”

Association of Rheumatoid Arthritis and Hepatitis B Infection: A Nationwide Nested Case-Control Study from 1999 to 2009 in Taiwan

“…The NHIRD has been described in detail in previous studies. 18,19 In brief, the NHIRD contains the registration data of all people who have been beneficiaries of the NHI program, which covered 99% of Taiwan's population and approximately 22,600,000 people in 2007. The NHRI maintains the NHIRD and provides it to scientists in Taiwan for research purposes.…”

Long-Term Follow-Up of Advanced Liver Disease after Sustained Virological Response to Treatment of Hepatitis C with Direct-Acting Antivirals: Outcomes from a Real-World Portuguese Cohort

“…The aims of antiviral therapy are to achieve virological cure; to prevent progression of liver disease and the occurrence of cirrhosis-related complications; to increase the quality of life and survival of patients; to remove the stigma associated with infection; and to prevent future transmission of the virus [8]. The accumulated data from interferon (IFN)-based treatments demonstrate a beneficent long-term clinical effect in patients who achieve SVR, by preventing the development of esophageal varices (EV), reducing the risk of HCC and the need for liver transplantation, and reducing liver-related mortality [2,[9][10][11][12]. The long-term histological regression of the grade of fibrosis was also documented, which reinforces the dynamic nature of fibrosis progression in the natural course of the disease [4,13,14].…”