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See 1 citation in Gut 2015:

Gut. 2015 Mar;64(3):495-503. doi: 10.1136/gutjnl-2014-308163. Epub 2014 Nov 14.

Association between antiviral treatment and extrahepatic outcomes in patients with hepatitis C virus infection.

Author information

1
Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan Center for Database Research, E-Da Hospital, Kaohsiung, Taiwan School of Medicine, I-Shou University, Kaohsiung, Taiwan.
2
Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.
3
Department of Epidemiology, Brown University, Providence, Rhode Island, USA.
4
Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
5
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
6
School of Medicine, Fu Jen Catholic University, New Taipei, Taiwan Center for Health Policy Research and Development, National Health Research Institutes, Miaoli, Taiwan.
7
Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan Center for Health Policy Research and Development, National Health Research Institutes, Miaoli, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan College of Public Health, China Medical University, Taichung, Taiwan Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan.

Abstract

OBJECTIVE:

To elucidate the association between antiviral therapy and extrahepatic outcomes in individuals infected with HCV.

METHODS:

This nationwide cohort study screened 293,480 Taiwanese residents with HCV infection and excluded those with substantial comorbidity. A total of 12,384 eligible patients who had received pegylated interferon plus ribavirin between 1 October 2003 and 31 December 2010 were enrolled in the treated cohort; they were matched 1 : 2 with 24,768 untreated controls in the propensity score and post-diagnosis treatment-free period. The incidences of end-stage renal disease (ESRD), acute coronary syndrome (ACS), ischaemic stroke and catastrophic autoimmune diseases were calculated after adjustment for competing mortality.

RESULTS:

The treated and untreated cohorts were followed up for a mean (±SD) duration of 3.3 (±2.5) and 3.2 (±2.4) years, respectively, until 31 December 2011. The calculated 8-year cumulative incidences of ESRD, ACS, ischaemic stroke and autoimmune catastrophes between treated and untreated patients were 0.15% vs. 1.32% (p<0.001), 2.21% vs. 2.96% (p=0.027), 1.31% vs. 1.76% (p=0.001) and 0.57% vs. 0.49% (p=0.816), respectively. Multivariate-adjusted Cox regression revealed that antiviral treatment was associated with lower risks of ESRD (HR 0.15; 95% CI 0.07 to 0.31; p<0.001), ACS (HR 0.77; 95% CI 0.62 to 0.97; p=0.026) and ischaemic stroke (HR 0.62; 95% CI 0.46 to 0.83; p=0.001), but unrelated to autoimmune catastrophes. These favourable associations were invalid in incompletely treated patients with duration <16 weeks.

CONCLUSIONS:

Antiviral treatment for HCV is associated with improved renal and circulatory outcomes, but unrelated to catastrophic autoimmune diseases.

KEYWORDS:

ANTIVIRAL THERAPY; HEPATITIS C

PMID:
25398770
DOI:
10.1136/gutjnl-2014-308163
[Indexed for MEDLINE]

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