Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.

<h4>Background</h4>The current antiviral treatments available for hepatitis C virus (HCV) infection decrease the risk of hepatocellular carcinoma (HCC). Hence, patients with HCV infection who have not received antiviral treatment and have developed HCC may be those who missed timely anti...

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Autores principales:	Dong Hyun Sinn, Danbee Kang, Yun Soo Hong, Kwang Cheol Koh, Eliseo Guallar, Juhee Cho, Geum-Youn Gwak
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/63bab615387944ddb35a3331d7449ba4
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spelling	oai:doaj.org-article:63bab615387944ddb35a3331d7449ba42021-12-02T20:18:49ZPrior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.1932-620310.1371/journal.pone.0255624https://doaj.org/article/63bab615387944ddb35a3331d7449ba42021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255624https://doaj.org/toc/1932-6203<h4>Background</h4>The current antiviral treatments available for hepatitis C virus (HCV) infection decrease the risk of hepatocellular carcinoma (HCC). Hence, patients with HCV infection who have not received antiviral treatment and have developed HCC may be those who missed timely antiviral treatment for HCV. However, the proportion of patients who missed timely antiviral treatment and its implications are largely unexplored.<h4>Methods</h4>A nationwide retrospective cohort of 4,592 newly diagnosed HCV-related HCC patients (2013-2017) was identified from the Korean National Health Insurance Service database. Prior antiviral treatment for HCV was defined as a history of at least one HCV-specific antiviral treatment before HCC diagnosis. The outcome was all-cause mortality.<h4>Results</h4>Prior antiviral treatment for HCV was identified in 802 (17.4%) patients, and 16%, 16%, 17%, 19%, and 19% of patients received antiviral treatment in the years 2013, 2014, 2015, 2016, and 2017, respectively (P = 0.21). During 8,085 person-years of follow-up (median, 1.4; maximum, 5.3 years of follow-up), 1,970 patients died. Mortality rates were lower in patients with prior antiviral treatment (15 deaths/100 person-years) than in those without prior antiviral treatment (27 deaths/100 person-years). The adjusted hazard ratio (95% confidence interval) for all-cause mortality on comparing patients who did and did not receive prior antiviral treatment was 0.68 (0.59, 0.79).<h4>Conclusion</h4>Timely antiviral treatment for HCV was suboptimal at the population level. Prior antiviral treatment for HCV reduced mortality rate in HCV-related HCC patients. Intensive HCV control strategies are needed to reduce the number of patients with HCV infection who miss timely HCV treatment.Dong Hyun SinnDanbee KangYun Soo HongKwang Cheol KohEliseo GuallarJuhee ChoGeum-Youn GwakPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255624 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dong Hyun Sinn Danbee Kang Yun Soo Hong Kwang Cheol Koh Eliseo Guallar Juhee Cho Geum-Youn Gwak Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.
description	<h4>Background</h4>The current antiviral treatments available for hepatitis C virus (HCV) infection decrease the risk of hepatocellular carcinoma (HCC). Hence, patients with HCV infection who have not received antiviral treatment and have developed HCC may be those who missed timely antiviral treatment for HCV. However, the proportion of patients who missed timely antiviral treatment and its implications are largely unexplored.<h4>Methods</h4>A nationwide retrospective cohort of 4,592 newly diagnosed HCV-related HCC patients (2013-2017) was identified from the Korean National Health Insurance Service database. Prior antiviral treatment for HCV was defined as a history of at least one HCV-specific antiviral treatment before HCC diagnosis. The outcome was all-cause mortality.<h4>Results</h4>Prior antiviral treatment for HCV was identified in 802 (17.4%) patients, and 16%, 16%, 17%, 19%, and 19% of patients received antiviral treatment in the years 2013, 2014, 2015, 2016, and 2017, respectively (P = 0.21). During 8,085 person-years of follow-up (median, 1.4; maximum, 5.3 years of follow-up), 1,970 patients died. Mortality rates were lower in patients with prior antiviral treatment (15 deaths/100 person-years) than in those without prior antiviral treatment (27 deaths/100 person-years). The adjusted hazard ratio (95% confidence interval) for all-cause mortality on comparing patients who did and did not receive prior antiviral treatment was 0.68 (0.59, 0.79).<h4>Conclusion</h4>Timely antiviral treatment for HCV was suboptimal at the population level. Prior antiviral treatment for HCV reduced mortality rate in HCV-related HCC patients. Intensive HCV control strategies are needed to reduce the number of patients with HCV infection who miss timely HCV treatment.
format	article
author	Dong Hyun Sinn Danbee Kang Yun Soo Hong Kwang Cheol Koh Eliseo Guallar Juhee Cho Geum-Youn Gwak
author_facet	Dong Hyun Sinn Danbee Kang Yun Soo Hong Kwang Cheol Koh Eliseo Guallar Juhee Cho Geum-Youn Gwak
author_sort	Dong Hyun Sinn
title	Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.
title_short	Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.
title_full	Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.
title_fullStr	Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.
title_full_unstemmed	Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.
title_sort	prior antiviral treatment and mortality among patients with hepatitis c virus-related hepatocellular carcinoma: a national cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/63bab615387944ddb35a3331d7449ba4
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Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study.

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