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Long-term outcome after interferon therapy in elderly patients with chronic hepatitis C.
Intervirology. 2007; 50(1):16-23.I

Abstract

OBJECTIVE

The purpose of this study was to elucidate the long-term outcome after interferon (IFN) therapy in chronic hepatitis C elderly patients.

METHODS

We studied the incidence of hepatocellular carcinoma (HCC) and survival probability after the initiation of IFN therapy in 500 Japanese chronic hepatitis C patients >60 years. The mean age of initiation of IFN was 63 years and the mean follow-up period was 7.4 years. Cox proportional hazard regression analysis was used to evaluate the long-term outcome after initiation of IFN therapy. Sustained virological response (SVR) was defined as negative HCV-RNA by RT-nested PCR 6 months after the completion of long-term IFN therapy. Non-response (NR) was applied to patients who did not show SVR. Hepatic fibrosis was defined as the fibrosis score (score 0-4) according to Knodell et al.

RESULTS

140 patients (28%) had an SVR and 360 patients (72%) had an NR. 71 of 500 patients developed HCC during follow-up. The cumulative incidence of HCC was 9.6% at the 5th year, 17.4% at the 10th year, and 31.3% at the 15th year. HCC developed with significance when: (1) HCV was not cleared after IFN therapy (p < 0.0001), (2) sex was male (p < 0.0001), and (3) staging of liver fibrosis was >2 (p = 0.008). 53 of the patients died. The cumulative survival probability was 95.7% at the 5th year, 86.4% at the 10th year, and 78% at the 15th year. Patients achieved a long survival with significance when: (1) staging of liver fibrosis was 1 (p < 0.0001), (2) HCV was cleared after IFN therapy (p = 0.034), and (3) sex was female (p = 0.015).

CONCLUSION

Chronic hepatitis C patients with clearance of HCV after IFN therapy had a significantly reduced risk of HCC appearance and achieved prolonged survival even if they are > or =60 years.

Authors+Show Affiliations

Department of Gastroenterology, and Hepatic Research Unit, Toranomon Hospital, Toranomon, Tokyo, Japan. es9y-ars@asahi-net.or.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17164553

Citation

Arase, Yasuji, et al. "Long-term Outcome After Interferon Therapy in Elderly Patients With Chronic Hepatitis C." Intervirology, vol. 50, no. 1, 2007, pp. 16-23.
Arase Y, Ikeda K, Suzuki F, et al. Long-term outcome after interferon therapy in elderly patients with chronic hepatitis C. Intervirology. 2007;50(1):16-23.
Arase, Y., Ikeda, K., Suzuki, F., Suzuki, Y., Saitoh, S., Kobayashi, M., Akuta, N., Someya, T., Koyama, R., Hosaka, T., Sezaki, H., Kobayashi, M., & Kumada, H. (2007). Long-term outcome after interferon therapy in elderly patients with chronic hepatitis C. Intervirology, 50(1), 16-23.
Arase Y, et al. Long-term Outcome After Interferon Therapy in Elderly Patients With Chronic Hepatitis C. Intervirology. 2007;50(1):16-23. PubMed PMID: 17164553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcome after interferon therapy in elderly patients with chronic hepatitis C. AU - Arase,Yasuji, AU - Ikeda,Kenji, AU - Suzuki,Fumitaka, AU - Suzuki,Yoshiyuki, AU - Saitoh,Satoshi, AU - Kobayashi,Masahiro, AU - Akuta,Norio, AU - Someya,Takashi, AU - Koyama,Rikako, AU - Hosaka,Tetsuya, AU - Sezaki,Hitomi, AU - Kobayashi,Mariko, AU - Kumada,Hiromitsu, PY - 2005/12/14/received PY - 2005/12/21/accepted PY - 2006/12/14/pubmed PY - 2007/2/7/medline PY - 2006/12/14/entrez SP - 16 EP - 23 JF - Intervirology JO - Intervirology VL - 50 IS - 1 N2 - OBJECTIVE: The purpose of this study was to elucidate the long-term outcome after interferon (IFN) therapy in chronic hepatitis C elderly patients. METHODS: We studied the incidence of hepatocellular carcinoma (HCC) and survival probability after the initiation of IFN therapy in 500 Japanese chronic hepatitis C patients >60 years. The mean age of initiation of IFN was 63 years and the mean follow-up period was 7.4 years. Cox proportional hazard regression analysis was used to evaluate the long-term outcome after initiation of IFN therapy. Sustained virological response (SVR) was defined as negative HCV-RNA by RT-nested PCR 6 months after the completion of long-term IFN therapy. Non-response (NR) was applied to patients who did not show SVR. Hepatic fibrosis was defined as the fibrosis score (score 0-4) according to Knodell et al. RESULTS: 140 patients (28%) had an SVR and 360 patients (72%) had an NR. 71 of 500 patients developed HCC during follow-up. The cumulative incidence of HCC was 9.6% at the 5th year, 17.4% at the 10th year, and 31.3% at the 15th year. HCC developed with significance when: (1) HCV was not cleared after IFN therapy (p < 0.0001), (2) sex was male (p < 0.0001), and (3) staging of liver fibrosis was >2 (p = 0.008). 53 of the patients died. The cumulative survival probability was 95.7% at the 5th year, 86.4% at the 10th year, and 78% at the 15th year. Patients achieved a long survival with significance when: (1) staging of liver fibrosis was 1 (p < 0.0001), (2) HCV was cleared after IFN therapy (p = 0.034), and (3) sex was female (p = 0.015). CONCLUSION: Chronic hepatitis C patients with clearance of HCV after IFN therapy had a significantly reduced risk of HCC appearance and achieved prolonged survival even if they are > or =60 years. SN - 0300-5526 UR - https://www.unboundmedicine.com/medline/citation/17164553/Long_term_outcome_after_interferon_therapy_in_elderly_patients_with_chronic_hepatitis_C_ L2 - https://www.karger.com?DOI=10.1159/000096308 DB - PRIME DP - Unbound Medicine ER -