期刊论文详细信息
BMC Gastroenterology
Effects and Outcomes of Interferon Treatment in Japanese Hepatitis C Patients
Satoshi Shirahama3  Kazuhiro Hirase4  Toshiaki Shimoda4  Michio Sata5  Yumiko Nagao2  Mayumi Tomohiro4  Kazumi Yamasaki1 
[1] Narao Medical Center, 712-3 Narao-go Shinkamigoto-cho Minamimatsuura-gun, Nagasaki, Japan;Department of Digestive Disease Information & Research, Kurume University School of Medicine, Kurume, Fukuoka, Japan;Arikawa Medical Center, Shinkamigoto, Japan;Kamigoto Hospital, Shinkamigoto, Japan;Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
关键词: Life expectancy;    Interferon;    Prospective cohort study;    Hepatocellular carcinoma;    Hepatitis C virus;   
Others  :  858364
DOI  :  10.1186/1471-230X-12-139
 received in 2012-06-01, accepted in 2012-09-28,  发布年份 2012
【 摘 要 】

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.

【 授权许可】

   
2012 Yamasaki et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Yokosuka O, Kato N, Hosoda K, Ito Y, Imazeki F, Ohto M, Omata M: Efficacy of long-term interferon treatment in chronic liver disease evaluated by sensitive polymerase chain reaction assay for hepatitis C virus RNA. Gut 1995, 37:721-726.
  • [2]Sata M, Nakano H, Suzuki H, Noguchi S, Yamakawa Y, Tanaka E, Fukuizumi K, Tanaka K, Yoshida H, Tanikawa K: Sero-epidemiologic study of hepatitis C virus infection in Fukuoka, Japan. J Gastroenterol 1998, 33:218-222.
  • [3]Kiyosawa K, Sodeyama T, Tanaka E, Gibo Y, Yoshizawa K, Nakano Y, Furuta S, Akahane Y, Nishioka K, Purcell RH, Alter HJ: Interrelationship of blood transfusion, non-A, non-B hepatitis and hepatocellular carcinoma. Analysis by detection of antibody to hepatitis C virus. Hepatology 1990, 12:671-675.
  • [4]Yano M, Kumada H, Kage M, Ikeda K, Shimamatsu K, Inoue O, Hashimoto E, Lefkowitch JH, Ludwig J, Okuda K: The long-term pathological evolution of chronic hepatitis C. Hepatology 1996, 23:1334-1340.
  • [5]Ikeda K, Saitoh S, Suzuki Y, Kobayashi M, Tsubota A, Koida I, Arase Y, Fukuda M, Chayama K, Murashima N, Kumada H: Disease progression and hepatocellular carcinogenesis in patients with chronic viral hepatitis: a prospective observation of 2215 patients. J Hepatol 1998, 28:930-938.
  • [6]Yoshida H, Shiratori Y, Moriyama M, Arakawa Y, Ide T, Sata M, Inoue O, Yano M, Tanaka M, Fujiyama S, Nishiguchi S, Kuroki T, Imazeki F, Yokosuka O, Kinoyama S, Yamada G, Omata M: Interferon therapy reduces the risk for hepatocellular carcinoma: national surveillance program of cirrhotic and noncirrhotic patients with chronic hepatitis C in Japan. Ann Intern Med 1999, 131:174-181.
  • [7]Nagao Y, Fukuizumi K, Kumashiro R, Tanaka K, Sata M: The prognosis for life in an HCV hyperendemic area. Gastroenterology 2003, 125:628-629.
  • [8]Nagao Y, Tanaka K, Kobayashi K, Kumashiro R, Sata M: A cohort study of chronic liver disease in an HCV hyperendemic area of Japan: a prospective analysis for 12 years. Int J Mol Med 2004, 13:257-265.
  • [9]Davis GL, Balart LA, Schiff ER, Lindsay K, Bodenheimer HC Jr, Perrillo RP, Carey W, Jacobson IM, Payne J, Dienstag JL, VanThiel DH, Carlo Tamburro C, Lefkowitch J, Albrecht J, Meschievitz C, Ortego TJ, Gibas A, The Hepatitis Interventional Therapy Group: Treatment of chronic hepatitis C with recombinant interferon alpha. A multi-center randomized controlled trial. N Engl J Med 1989, 321:1501-1506.
  • [10]Di Bisceglie AM, Martin P, Kassianides C, Lisker-Melman M, Murray L, Waggoner J, Goodman Z, Banks SM, Hoofnagle JH: Recombinant interferon alpha therapy for chronic hepatitis C. A randomized, double blind placebo-controlled trial. N Engl J Med 1989, 321:1506-1510.
  • [11]Hagiwara H, Hayashi N, Mita E, Ueda K, Takehara T, Kasahara A, Fusamoto H, Kamada T: Detection of hepatitis C virus RNA in serum of patients with chronic hepatitis C treated with interferon-α. Hepatology 1992, 15:37-41.
  • [12]Hagiwara H, Hayashi N, Mita E, Takehara T, Kasahara A, Fusamoto H, Kamada T: Quantitative analysis of hepatitis C virus RNA in serum during interferon alpha therapy. Gastroenterology 1993, 104:877-883.
  • [13]Kasahara A, Hayashi N, Hiramatsu N, Oshita M, Hagiwara H, Katayama K, Kato M, Masuzawa M, Yoshihara H, Kishida Y, Shimizu Y, Inoue A, Fusamoto H, Kamada T: Ability of prolonged interferon treatment to suppress relapse after cessation of therapy in patients with chronic hepatitis C: a multi-center randomized controlled trial. Hepatology 1995, 21:291-297.
  • [14]Shiratori Y, Imazeki F, Moriyama M, Yano M, Arakawa Y, Yokosuka O, Kuroki T, Nishiguchi S, Sata M, Yamada G, Fujiyama S, Yoshida H, Omata M: Histologic improvement of fibrosis in patients with hepatitis C who have showed sustained response to interferon therapy. Ann Intern Med 2000, 132:517-524.
  • [15]Hiramatsu N, Hayashi N, Kasahara A, Hagiwara H, Takehara T, Haruna Y, Naito M, Fusamoto H, Kamada T: Improvement of liver fibrosis in chronic hepatitis C patients treated with natural interferon alpha. J Hepatol 1995, 22:135-142.
  • [16]Hung CH, Lee CM, Lu SN, Wang JH, Hu TH, Tung HD, Chen CH, Chen WJ, Changchien CS: Long-term effect of interferon alfa-2b plus ribavirin therapy on incidence of hepatocellular carcinoma in patients with hepatitis C-related cirrhosis. J Viral Hepat 2006, 13:409-414.
  • [17]Niederau C, Lange S, Heintges T, Erhardt A, Buschkamp M, Hürter D, Nawrocki M, Kruska L, Hensel F, Petry W, Häussinger D: Prognosis of chronic hepatitis C: results of a large prospective cohort study. Hepatology 1998, 28:1687-1695.
  • [18]Yoshida H, Arakawa Y, Sata M, Nishiguchi S, Yano M, Fujiyama S, Yamada G, Yokosuka O, Shiratori Y, Omata M: Interferon therapy prolonged life expectancy among chronic hepatitis C patients. Gastroenterology 2002, 123:483-491.
  • [19]Kasahara A, Tanaka H, Okanoue T, Imai Y, Tsubouchi H, Yoshioka K, Kawata S, Tanaka E, Hino K, Hayashi K, Tamura S, Itoh Y, Kiyosawa K, Kakumu S, Okita K, Hayashi N: Interferon treatment improves survival in chronic hepatitis C patients showing biochemical as well as virological responses by preventing liver-related death. J Viral Hepat 2004, 11:148-156.
  • [20]Desmet VJ, Gerber M, Hoofnagle JH, Manns M, Scheuer PJ: Classification of chronic hepatitis: diagnosis, grading, grading, and staging. Hepatology 1994, 19:1513-1520.
  • [21]Kasahara A, Hayashi N, Mochizuki K, Takayanagi M, Yoshioka K, Kakumu S, Iijima A, Urushihara A, Kiyosawa K, Okuda M, Hino K, Okita K: Risk factors for hepatocellular carcinoma and its incidence after interferon treatment in patients with chronic hepatitis C. Hepatology 1998, 27:1394-1402.
  • [22]Ikeda K, Saitoh S, Arase Y, Chayama K, Suzuki Y, Kobayashi M, Tsubota A, Nakamura I, Murashima N, Kumada H, Kawanishi M: Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: a long-term observation study of 1643 patients using statistical bias correction with proportional hazard analysis. Hepatology 1999, 29:1124-1130.
  • [23]Okanoue T, Itoh Y, Minami M, Sakamoto S, Yasui K, Sakamoto M, Nishioji K, Murakami Y, Kashima K: Interferon therapy lowers the rate of progression to hepatocellular carcinoma in chronic hepatitis C but not significantly in an advanced stage; a retrospective study of 1146 patients. J Hepatol 1999, 30:653-659.
  • [24]Benvegnù L, Chemello L, Noventa F, Fattovich G, Pontisso P, Alberti A: Retrospective analysis of the effect of interferon therapy on the clinical outcome of patients with viral cirrhosis. Cancer 1998, 83:901-909.
  • [25]Valla DC, Chevallier M, Marcellin P, Payen JL, Trepo C, Fonck M, Bourliere M, Boucher E, Miguet JP, Parlier D, Lemonnier C, Opolon P: Treatment of hepatitis C virus-related cirrhosis: a randomized, controlled trial of interferon alpha-2b versus no treatment. Hepatology 1999, 29:1870-1875.
  • [26]Serfaty L, Aumaître H, Chazouillères O, Bonnand AM, Rosmorduc O, Poupon RE, Poupon R: Determinants of outcome of compensated hepatitis C virus-related cirrhosis. Hepatology 1998, 27:1435-1440.
  • [27]Nishiguchi S, Shiomi S, Nakatani S, Takeda T, Fukuda K, Tamori A, Habu D, Tanaka T: Prevention of hepatocellular carcinoma in patients with chronic active hepatitis C and cirrhosis. Lancet 2001, 357:196-197.
  • [28]Nagao Y, Kawakami Y, Yoshiyama T, Sata M: Analysis of factors interfering with the acceptance of interferon therapy by HCV-infected patients. Med Sci Monit 2008, 14:45-52.
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