Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Rutter, K; Stättermayer, AF; Beinhardt, S; Scherzer, TM; Steindl-Munda, P; Trauner, M; Ferenci, P; Hofer, H.
Successful anti-viral treatment improves survival of patients with advanced liver disease due to chronic hepatitis C.
Aliment Pharmacol Ther. 2015; 41(6):521-531
Doi: 10.1111/apt.13085
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- Co-Autor*innen der Med Uni Graz
- Trauner Michael
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- Abstract:
- Long-term outcome of chronic hepatitis C patients with successful viral eradication seems to be promising. To evaluate mortality, incidence of hepatocellular carcinoma (HCC), liver failure and liver transplantation in sustained virological responders (SVR) and non-SVR patients with different stages of fibrosis. Seven hundred and fourteen patients with a follow-up of 7.2 (1-21.1) years (age: 51.4 ± 12.0 years, 276 female, IFN-monotherapy: n = 19, IFN/RBV: n = 122, peg-IFN/RBV: n = 573, SVR: 551, non-SVR: 163) were studied. Two hundred and ten of 540 patients with a liver biopsy prior to treatment had advanced stages of fibrosis (Metavir F3/F4). Forty-eight patients died during follow-up, 15 with SVR and 33 without (P < 0.001). Five- and 10-year mortality rates were 1.8% (10/551) and 2.7% (15/551) in the SVR group and 8.6% (14/163) and 19.1% (31/163) in the non-SVR patients (P < 0.001). In 29 patients, decompensation of liver disease [SVR: 9 (1.6%) vs. non-SVR: 20 (12.3%); P < 0.001] occurred and in 29 patients, HCC developed during follow-up [SVR: 10 (1.8%) vs. non-SVR: 19 (11.7%); P < 0.001]. Non-SVR was an independent predictor for developing (i) HCC [HR: 2.36 (95% CI: 1.07-5.23; P = 0.034], (ii) liver-related complications [HR: 2.62; (95% CI: 1.18-5.81; P = 0.018] and (iii) mortality (HR: 3.46; 95% CI: 1.91-6.29; P < 0.001). For patients with early stages of fibrosis (F0-F2), a survival benefit of SVR patients could not be demonstrated. Successful anti-viral therapy decreases mortality, incidence of hepatocellular carcinoma and liver failure in patients with advanced fibrosis. However, hepatocellular carcinoma development or liver failure are not prevented completely, and further follow-up of patients is advisable. © 2015 John Wiley & Sons Ltd.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Antiviral Agents - therapeutic use
- Carcinoma, Hepatocellular - epidemiology
- Carcinoma, Hepatocellular - virology
- Female -
- Follow-Up Studies -
- Hepatitis C, Chronic - complications
- Hepatitis C, Chronic - drug therapy
- Humans -
- Liver Failure - epidemiology
- Liver Failure - virology
- Liver Neoplasms - epidemiology
- Liver Neoplasms - virology
- Liver Transplantation - statistics & numerical data
- Male -
- Middle Aged -
- Retrospective Studies -