Dataset Information

Improved Survival Among all Interferon-α-Treated Patients in HCV-002, a Veterans Affairs Hepatitis C Cohort of 2211 Patients, Despite Increased Cirrhosis Among Nonresponders.

ABSTRACT:

Background

As the era of interferon-alpha (IFN)-based therapy for hepatitis C ends, long-term treatment outcomes are now being evaluated.

Aim

To more fully understand the natural history of hepatitis C infection by following a multisite cohort of patients.

Methods

Patients with chronic HCV were prospectively enrolled in 1999-2000 from 11 VA medical centers and followed through retrospective medical record review.

Results

A total of 2211 patients were followed for an average of 8.5 years after enrollment. Thirty-one percent of patients received HCV antiviral therapy, 15 % with standard IFN/ribavirin only, 16 % with pegylated IFN/ribavirin, and 26.7 % of treated patients achieved sustained virologic response (SVR). Cirrhosis developed in 25.8 % of patients. Treatment nonresponders had a greater than twofold increase in the hazard of cirrhosis and hepatocellular carcinoma, compared to untreated patients, whereas SVR patients were only marginally protected from cirrhosis. Nearly 6 % developed hepatocellular carcinoma, and 27.1 % died during the follow-up period. Treated patients, regardless of response, had a significant survival benefit compared to untreated patients (HR 0.58, CI 0.46-0.72). Improved survival was also associated with college education, younger age, lower levels of alcohol consumption, and longer duration of medical service follow-up-factors typically associated with treatment eligibility.

Conclusions

As more hepatitis C patients are now being assessed for all-oral combination therapy, these results highlight that patient compliance and limiting harmful behaviors contribute a significant proportion of the survival benefit in treated patients and that the long-term clinical benefits of SVR may be less profound than previously reported.

SUBMITTER: Cozen ML

PROVIDER: S-EPMC5308124 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Publications

Improved Survival Among all Interferon-α-Treated Patients in HCV-002, a Veterans Affairs Hepatitis C Cohort of 2211 Patients, Despite Increased Cirrhosis Among Nonresponders.

Cozen Myrna L ML Ryan James C JC Shen Hui H Cheung Ramsey R Kaplan David E DE Pocha Christine C Brau Norbert N Aytaman Ayse A Schmidt Warren N WN Pedrosa Marcos M Anand Bhupinderjit S BS Chang Kyong-Mi KM Morgan Timothy T Monto Alexander A

Digestive diseases and sciences 20160408 6

<h4>Background</h4>As the era of interferon-alpha (IFN)-based therapy for hepatitis C ends, long-term treatment outcomes are now being evaluated.<h4>Aim</h4>To more fully understand the natural history of hepatitis C infection by following a multisite cohort of patients.<h4>Methods</h4>Patients with chronic HCV were prospectively enrolled in 1999-2000 from 11 VA medical centers and followed through retrospective medical record review.<h4>Results</h4>A total of 2211 patients were followed for an ...[more]

PMID: 27059981

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Dataset Information

Improved Survival Among all Interferon-α-Treated Patients in HCV-002, a Veterans Affairs Hepatitis C Cohort of 2211 Patients, Despite Increased Cirrhosis Among Nonresponders.

Background

Aim

Methods

Results

Conclusions

Publications

Improved Survival Among all Interferon-α-Treated Patients in HCV-002, a Veterans Affairs Hepatitis C Cohort of 2211 Patients, Despite Increased Cirrhosis Among Nonresponders.

Similar Datasets

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