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Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality

Whether a sustained virological response (SVR) improves long-term outcomes in chronic hepatitis C patients with earlier-stage fibrosis has not been established. We investigated the differential effect of SVR on the risk of outcomes according to hepatic fibrosis grade. Fibrosis grade was categorised...

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Autores principales: Lee, Yun Bin, Nam, Joon Yeul, Lee, Jeong-Hoon, Chang, Young, Cho, Hyeki, Cho, Young Youn, Cho, Eun Ju, Yu, Su Jong, Kim, Hwi Young, Lee, Dong Ho, Lee, Jeong Min, Hwang, Seong Gyu, Kim, Yoon Jun, Yoon, Jung-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6135856/
https://www.ncbi.nlm.nih.gov/pubmed/30209336
http://dx.doi.org/10.1038/s41598-018-31839-y
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author Lee, Yun Bin
Nam, Joon Yeul
Lee, Jeong-Hoon
Chang, Young
Cho, Hyeki
Cho, Young Youn
Cho, Eun Ju
Yu, Su Jong
Kim, Hwi Young
Lee, Dong Ho
Lee, Jeong Min
Hwang, Seong Gyu
Kim, Yoon Jun
Yoon, Jung-Hwan
author_facet Lee, Yun Bin
Nam, Joon Yeul
Lee, Jeong-Hoon
Chang, Young
Cho, Hyeki
Cho, Young Youn
Cho, Eun Ju
Yu, Su Jong
Kim, Hwi Young
Lee, Dong Ho
Lee, Jeong Min
Hwang, Seong Gyu
Kim, Yoon Jun
Yoon, Jung-Hwan
author_sort Lee, Yun Bin
collection PubMed
description Whether a sustained virological response (SVR) improves long-term outcomes in chronic hepatitis C patients with earlier-stage fibrosis has not been established. We investigated the differential effect of SVR on the risk of outcomes according to hepatic fibrosis grade. Fibrosis grade was categorised using FIB-4: <1.45, low-probability of significant fibrosis; 1.45–3.25, intermediate-probability; and ≥3.25, high-probability. Primary and secondary endpoints were hepatocellular carcinoma (HCC) occurrence and death, respectively. Among 1,373 included chronic hepatitis C patients, 744 patients were treated with interferon-based or –free regimens and 622 (83.6%) achieved SVR. SVR was independently associated with lower risk of HCC (vs. untreated: adjusted hazard ratio [aHR], 0.165; 95% confidence interval [CI], 0.077–0.350; P < 0.001) and overall death (vs. untreated; aHR, 0.146; 95% CI, 0.050–0.424; P < 0.001) during the median observation of 3.5 (interquartile range, 1.9–6.6) years. The SVR group had significantly lower risk of HCC than the untreated group among patients with intermediate-probability (n = 492: aHR, 0.171; 95% CI, 0.051–0.578; P = 0.004) and high-probability (n = 446: aHR, 0.243; 95% CI, 0.107–0.551; P < 0.001) of significant fibrosis. HRs were maintained after balancing with inverse probability weighting. SVR was associated with reduced risk of HCC development and all-cause mortality in patients with chronic hepatitis C.
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spelling pubmed-61358562018-09-15 Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality Lee, Yun Bin Nam, Joon Yeul Lee, Jeong-Hoon Chang, Young Cho, Hyeki Cho, Young Youn Cho, Eun Ju Yu, Su Jong Kim, Hwi Young Lee, Dong Ho Lee, Jeong Min Hwang, Seong Gyu Kim, Yoon Jun Yoon, Jung-Hwan Sci Rep Article Whether a sustained virological response (SVR) improves long-term outcomes in chronic hepatitis C patients with earlier-stage fibrosis has not been established. We investigated the differential effect of SVR on the risk of outcomes according to hepatic fibrosis grade. Fibrosis grade was categorised using FIB-4: <1.45, low-probability of significant fibrosis; 1.45–3.25, intermediate-probability; and ≥3.25, high-probability. Primary and secondary endpoints were hepatocellular carcinoma (HCC) occurrence and death, respectively. Among 1,373 included chronic hepatitis C patients, 744 patients were treated with interferon-based or –free regimens and 622 (83.6%) achieved SVR. SVR was independently associated with lower risk of HCC (vs. untreated: adjusted hazard ratio [aHR], 0.165; 95% confidence interval [CI], 0.077–0.350; P < 0.001) and overall death (vs. untreated; aHR, 0.146; 95% CI, 0.050–0.424; P < 0.001) during the median observation of 3.5 (interquartile range, 1.9–6.6) years. The SVR group had significantly lower risk of HCC than the untreated group among patients with intermediate-probability (n = 492: aHR, 0.171; 95% CI, 0.051–0.578; P = 0.004) and high-probability (n = 446: aHR, 0.243; 95% CI, 0.107–0.551; P < 0.001) of significant fibrosis. HRs were maintained after balancing with inverse probability weighting. SVR was associated with reduced risk of HCC development and all-cause mortality in patients with chronic hepatitis C. Nature Publishing Group UK 2018-09-12 /pmc/articles/PMC6135856/ /pubmed/30209336 http://dx.doi.org/10.1038/s41598-018-31839-y Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Lee, Yun Bin
Nam, Joon Yeul
Lee, Jeong-Hoon
Chang, Young
Cho, Hyeki
Cho, Young Youn
Cho, Eun Ju
Yu, Su Jong
Kim, Hwi Young
Lee, Dong Ho
Lee, Jeong Min
Hwang, Seong Gyu
Kim, Yoon Jun
Yoon, Jung-Hwan
Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality
title Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality
title_full Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality
title_fullStr Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality
title_full_unstemmed Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality
title_short Differential Effect of HCV Eradication and Fibrosis Grade on Hepatocellular Carcinoma and All-cause Mortality
title_sort differential effect of hcv eradication and fibrosis grade on hepatocellular carcinoma and all-cause mortality
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6135856/
https://www.ncbi.nlm.nih.gov/pubmed/30209336
http://dx.doi.org/10.1038/s41598-018-31839-y
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