TY - JOUR
T1 - Effect of peginterferon alfa-2b and ribavirin on hepatocellular carcinoma prevention in older patients with chronic hepatitis C
AU - Honda, Takashi
AU - Ishigami, Masatoshi
AU - Masuda, Hiroko
AU - Ishizu, Yoji
AU - Kuzuya, Teiji
AU - Hayashi, Kazuhiko
AU - Itoh, Akihiro
AU - Hirooka, Yoshiki
AU - Nakano, Isao
AU - Ishikawa, Tetsuya
AU - Urano, Fumihiro
AU - Yoshioka, Kentaro
AU - Toyoda, Hidenori
AU - Kumada, Takashi
AU - Katano, Yoshiaki
AU - Goto, Hidemi
N1 - Publisher Copyright:
© 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background and Aims: The population of patients chronically infected with hepatitis C virus (HCV) is aging, and the number of older patients with HCV-related hepatocellular carcinoma (HCC) is increasing. The purpose of this study was to elucidate the effects of peginterferon and ribavirin combination therapy on prevention of HCC in older patients with chronic hepatitis C (CH-C). Methods: We compared the sustained virological response (SVR) and treatment discontinuation rates between older (≥65 years) and younger patients (<65 years) among 1280 CH-C patients treated with peginterferon alfa-2b and ribavirin. Cumulative incidence of HCC was determined by Kaplan-Meier analysis, and factors associated with liver carcinogenesis were analyzed by Cox proportional hazards regression. Results: Older patients had a significantly lower SVR rate and a significantly higher discontinuation rate of treatment than younger patients. Fifty patients developed HCC during median follow-up period of 47 months. Cox proportional hazards regression analysis indicated that the following were independent risk factors associated with the development of HCC: older age, male, advanced fibrosis, non-SVR in all patients: higher gamma-glutamyltranspeptidase, and non-SVR in older patients. Older patients who achieved SVR had a significantly reduced rate of HCC compared with those who did not achieve SVR, especially those who had gamma-glutamyltranspeptidase over 44IU/L. Conclusions: The SVR rate was lower and the combination therapy discontinuation rate was higher in older CH-C patients than in younger patients. However, older patients who achieved SVR had a markedly lower rate of HCC development compared with older patients who did not achieve SVR.
AB - Background and Aims: The population of patients chronically infected with hepatitis C virus (HCV) is aging, and the number of older patients with HCV-related hepatocellular carcinoma (HCC) is increasing. The purpose of this study was to elucidate the effects of peginterferon and ribavirin combination therapy on prevention of HCC in older patients with chronic hepatitis C (CH-C). Methods: We compared the sustained virological response (SVR) and treatment discontinuation rates between older (≥65 years) and younger patients (<65 years) among 1280 CH-C patients treated with peginterferon alfa-2b and ribavirin. Cumulative incidence of HCC was determined by Kaplan-Meier analysis, and factors associated with liver carcinogenesis were analyzed by Cox proportional hazards regression. Results: Older patients had a significantly lower SVR rate and a significantly higher discontinuation rate of treatment than younger patients. Fifty patients developed HCC during median follow-up period of 47 months. Cox proportional hazards regression analysis indicated that the following were independent risk factors associated with the development of HCC: older age, male, advanced fibrosis, non-SVR in all patients: higher gamma-glutamyltranspeptidase, and non-SVR in older patients. Older patients who achieved SVR had a significantly reduced rate of HCC compared with those who did not achieve SVR, especially those who had gamma-glutamyltranspeptidase over 44IU/L. Conclusions: The SVR rate was lower and the combination therapy discontinuation rate was higher in older CH-C patients than in younger patients. However, older patients who achieved SVR had a markedly lower rate of HCC development compared with older patients who did not achieve SVR.
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U2 - 10.1111/jgh.12703
DO - 10.1111/jgh.12703
M3 - Article
C2 - 25091027
AN - SCOPUS:84921474497
SN - 0815-9319
VL - 30
SP - 321
EP - 328
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 2
ER -