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

Abstract：

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.

journal_name

Clin Interv Aging

journal_title

Clinical interventions in aging

authors

Tseng CW,Chang TT,Tzeng SJ,Hsieh YH,Hung TH,Huang HT,Wu SF,Tseng KC

doi

10.2147/CIA.S97242

subject

Has Abstract

pub_date

2016-03-17 00:00:00

pages

327-34

eissn

1176-9092

issn

1178-1998

pii

cia-11-327

journal_volume

pub_type

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