Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C

Chih-Wei Tseng,1,2 Ting-Tsung Chang,3,4 Shinn-Jia Tzeng,5 Yu-Hsi Hsieh,1,2 Tsung-Hsing Hung,1,2 Hsiang-Ting Huang,6 Shu-Fen Wu,7 Kuo-Chih Tseng1,2 1Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, 2School of Medicine, Tzuchi University, Hualien,...

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Autores principales:	Tseng CW, Chang TT, Tzeng SJ, Hsieh YH, Hung TH, Huang HT, Wu SF, Tseng KC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	hepatitis C sustained virologic response pegylated interferon ribavirin liver cirrhosis Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/1507cab8cb0745f8a1ee26034acef6c1
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spelling	oai:doaj.org-article:1507cab8cb0745f8a1ee26034acef6c12021-12-02T04:02:37ZAssociation of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C1178-1998https://doaj.org/article/1507cab8cb0745f8a1ee26034acef6c12016-03-01T00:00:00Zhttps://www.dovepress.com/association-of-sustained-virologic-response-with-reduced-progression-t-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Chih-Wei Tseng,1,2 Ting-Tsung Chang,3,4 Shinn-Jia Tzeng,5 Yu-Hsi Hsieh,1,2 Tsung-Hsing Hung,1,2 Hsiang-Ting Huang,6 Shu-Fen Wu,7 Kuo-Chih Tseng1,2 1Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, 2School of Medicine, Tzuchi University, Hualien, 3Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, 4Infectious Disease and Signaling Research Center, National Cheng Kung University, Tainan, 5Department of Agronomy, National Chiayi University, 6Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 7Institute of Molecular Biology, National Chung Cheng University, Chia-Yi, Taiwan Objective: We studied the effect of sustained virologic response (SVR) after treatment with pegylated-interferon (PEG-IFN) plus ribavirin on the development of liver cirrhosis in elderly patients with chronic hepatitis C (CHC). Patients and methods: This retrospective study enrolled 145 elderly CHC patients (aged ≥65 years) who were treatment-naïve and were treated with PEG-IFN plus ribavirin for 6 months between January 2005 and December 2011. Abdominal sonography was performed and liver biochemistry was studied at baseline, at the end of treatment, and every 3–6 months thereafter. The development of liver cirrhosis and related complications was evaluated at the follow-ups. The aspartate aminotransferase-to-platelet ratio index was used as a noninvasive maker for fibrosis. Results: The mean patient age was 69.1±3.3 years, and the average follow-up time was 5.5 years (standard deviation: 2.5 years, range: 1.1–12.3 years). Ninety-five patients (65.5%) achieved SVR, and 26 (17.9%) discontinued treatment. Twenty-seven patients (18.6%) developed liver cirrhosis after treatment. Patients without SVR had significantly greater risk of liver cirrhosis than those with SVR (hazard ratio [HR]: 3.39, 95% confidence interval [CI]: 1.312–8.761, P=0.012). The difference in 3-year cumulative incidence of liver cirrhosis was 24.8% greater for patients without SVR (35.2%, 95% CI: 13.0–57.5, P=0.012) compared with those with SVR (10.4%, 95% CI: 3.1–17.7). There was a trend of a higher baseline aspartate aminotransferase-to-platelet ratio index score in patients who progressed to liver cirrhosis compared with those who did not progress (2.1±1.2 vs 1.6±1.3, P=0.055), but the difference failed to reach significance by Cox regression (adjusted HR: 1.285, 95% CI: 0.921–1.791, P=0.14). Conclusion: An SVR following PEG-IFN combination treatment can reduce the risk of liver cirrhosis in elderly CHC patients. Keywords: hepatitis C, sustained virologic response, pegylated interferon, ribavirin, liver cirrhosisTseng CWChang TTTzeng SJHsieh YHHung THHuang HTWu SFTseng KCDove Medical Pressarticlehepatitis Csustained virologic responsepegylated interferonribavirinliver cirrhosisGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 327-334 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	hepatitis C sustained virologic response pegylated interferon ribavirin liver cirrhosis Geriatrics RC952-954.6
spellingShingle	hepatitis C sustained virologic response pegylated interferon ribavirin liver cirrhosis Geriatrics RC952-954.6 Tseng CW Chang TT Tzeng SJ Hsieh YH Hung TH Huang HT Wu SF Tseng KC Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C
description	Chih-Wei Tseng,1,2 Ting-Tsung Chang,3,4 Shinn-Jia Tzeng,5 Yu-Hsi Hsieh,1,2 Tsung-Hsing Hung,1,2 Hsiang-Ting Huang,6 Shu-Fen Wu,7 Kuo-Chih Tseng1,2 1Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, 2School of Medicine, Tzuchi University, Hualien, 3Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, 4Infectious Disease and Signaling Research Center, National Cheng Kung University, Tainan, 5Department of Agronomy, National Chiayi University, 6Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 7Institute of Molecular Biology, National Chung Cheng University, Chia-Yi, Taiwan Objective: We studied the effect of sustained virologic response (SVR) after treatment with pegylated-interferon (PEG-IFN) plus ribavirin on the development of liver cirrhosis in elderly patients with chronic hepatitis C (CHC). Patients and methods: This retrospective study enrolled 145 elderly CHC patients (aged ≥65 years) who were treatment-naïve and were treated with PEG-IFN plus ribavirin for 6 months between January 2005 and December 2011. Abdominal sonography was performed and liver biochemistry was studied at baseline, at the end of treatment, and every 3–6 months thereafter. The development of liver cirrhosis and related complications was evaluated at the follow-ups. The aspartate aminotransferase-to-platelet ratio index was used as a noninvasive maker for fibrosis. Results: The mean patient age was 69.1±3.3 years, and the average follow-up time was 5.5 years (standard deviation: 2.5 years, range: 1.1–12.3 years). Ninety-five patients (65.5%) achieved SVR, and 26 (17.9%) discontinued treatment. Twenty-seven patients (18.6%) developed liver cirrhosis after treatment. Patients without SVR had significantly greater risk of liver cirrhosis than those with SVR (hazard ratio [HR]: 3.39, 95% confidence interval [CI]: 1.312–8.761, P=0.012). The difference in 3-year cumulative incidence of liver cirrhosis was 24.8% greater for patients without SVR (35.2%, 95% CI: 13.0–57.5, P=0.012) compared with those with SVR (10.4%, 95% CI: 3.1–17.7). There was a trend of a higher baseline aspartate aminotransferase-to-platelet ratio index score in patients who progressed to liver cirrhosis compared with those who did not progress (2.1±1.2 vs 1.6±1.3, P=0.055), but the difference failed to reach significance by Cox regression (adjusted HR: 1.285, 95% CI: 0.921–1.791, P=0.14). Conclusion: An SVR following PEG-IFN combination treatment can reduce the risk of liver cirrhosis in elderly CHC patients. Keywords: hepatitis C, sustained virologic response, pegylated interferon, ribavirin, liver cirrhosis
format	article
author	Tseng CW Chang TT Tzeng SJ Hsieh YH Hung TH Huang HT Wu SF Tseng KC
author_facet	Tseng CW Chang TT Tzeng SJ Hsieh YH Hung TH Huang HT Wu SF Tseng KC
author_sort	Tseng CW
title	Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C
title_short	Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C
title_full	Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C
title_fullStr	Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C
title_full_unstemmed	Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C
title_sort	association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis c
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/1507cab8cb0745f8a1ee26034acef6c1
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Association of sustained virologic response with reduced progression to liver cirrhosis in elderly patients with chronic hepatitis C

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