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Eur J Gastroenterol Hepatol. 2016 Apr;28(4):405-11. doi: 10.1097/MEG.0000000000000567.

Influence of female sex on hepatitis C virus infection progression and treatment outcomes.

Author information

1
aThe Ottawa Hospital Research Institute bThe Ottawa Hospital and Regional Viral Hepatitis Program Ottawa cThe University of Ottawa, Ottawa, Ontario, Canada.

Abstract

BACKGROUND:

The influence of sex on hepatitis C virus (HCV)-related outcomes is often neglected. The effects of sex on liver fibrosis progression and the effect of socioeconomic status on management are unclear.

PATIENTS AND METHODS:

Data were evaluated from patients followed at The Ottawa Hospital and Regional Viral Hepatitis Program.

RESULTS:

Of 1978 chronic HCV-infected patients, 630 (32%) were women. Women had lower liver enzyme levels, HCV RNA levels, and weight compared with men. Women were more likely to be non-genotype-1 infected, Black or Asian, and immigrants from Africa and Asia (all P<0.01). Under 50 years of age, women on average had lower fibrosis scores than men. Beyond the age of 50 years, the mean fibrosis scores were similar, suggesting a 'catch-up' phase. Women were less likely to have initiated interferon-based HCV antiviral therapy (35.3 vs. 43.3%, P=0.01). Crude sustained virological responses were higher in women (65.3 vs. 56.3%, P=0.03), but were similar to men as determined by multivariable analysis (odds ratio: 0.92, 95% confidence interval: 0.58-1.46). Women of low socioeconomic status were more likely to be HIV coinfected and had higher rates of fibrosis progression. Women living in low-income neighborhoods were less likely to achieve sustained virological response (odds ratio: 0.50, 95% confidence interval: 0.34-0.75, P=0.01) compared with women in higher income regions.

CONCLUSION:

Sex differences have been identified as a potential barrier to overcome when managing viral infections. Our analysis suggests that sex influences fibrosis progression, likelihood of initiating HCV antiviral therapy, and treatment outcomes.

PMID:
26745470
DOI:
10.1097/MEG.0000000000000567
[Indexed for MEDLINE]

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