TY - JOUR
T1 - Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients
AU - Hsu, Ching Sheng
AU - Huang, Chun Jen
AU - Kao, Jia Horng
AU - Lin, Hans Hsienhong
AU - Chao, You Chen
AU - Fan, Yen Chun
AU - Tsai, Pei Shan
N1 - Funding Information:
Ching-Sheng Hsu has received research grants from the Buddhist Tzu Chi General Hospital, Taipei Branch (TCRD-TPE-100-C1-2), the Department of Health, and the National Science Council, Executive Yuan, Taiwan (NSC99-2314-B-303-004). Jia-Horng Kao does consultancy for Abbott, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline, Merck Sharp & Dohme, Novartis, and Roche; on speaker’s bureaus for Abbott, Roche, Bayer, Bristol-Myers Squibb, GlaxoSmithKline, and Novartis. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.
PY - 2013/7/23
Y1 - 2013/7/23
N2 - Background:Interferon-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.Methods:This 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.Results:The 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
AB - Background:Interferon-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.Methods:This 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.Results:The 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
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U2 - 10.1371/journal.pone.0070458
DO - 10.1371/journal.pone.0070458
M3 - Article
C2 - 23894660
AN - SCOPUS:84880714667
SN - 1932-6203
VL - 8
JO - PLoS ONE
JF - PLoS ONE
IS - 7
M1 - e70458
ER -