Accelerated decline of lung function in COPD patients with chronic hepatitis C virus infection: a preliminary study based on small numbers of patients.
OBJECTIVE
It has been suggested that chronic viral infection may increase the risk for development of COPD. This prospective study was designed to determine that chronic hepatitis C virus (HCV) infection is associated with accelerated decline of lung function in patients with COPD, and that antiviral therapy against HCV is effective for such patients.


METHODS
Prospective 5-year follow-up study.


METHODS
University hospital.


METHODS
Fifty-nine patients with COPD (group A, 15 HCV-negative ex-smokers; group B, 14 HCV-negative current smokers; group C, 14 HCV-positive ex-smokers; group D, 16 HCV-positive current smokers).


METHODS
After a 5-year follow-up period, 21 HCV-positive patients received interferon (IFN)-alpha therapy.


RESULTS
The rate of annual decline in FEV(1) and diffusing capacity of the lung for carbon monoxide (DLCO) during the 5-year follow-up period were significantly higher in group B (DeltaFEV(1), 59.7 mL/yr [SD, 17.5], p = 0.0008; DeltaDLCO, 3.50%/yr [SD, 0.44], p < 0.0001) and group C (DeltaFEV(1), 54.0 mL/yr [SD, 15.3], p = 0.0128; DeltaDLCO, 3.36%/yr [SD, 0.28], p < 0.0001) than in group A (DeltaFEV(1), 33.5 mL/yr [SD, 7.7]; DeltaDLCO, 2.66%/yr [SD, 0.34]). Moreover, these parameters in group D (DeltaFEV(1), 79.5 mL/yr [SD, 20.6]; DLCO, 4.5%/yr [SD, 0.40]) were also significantly higher than those in group B and group C. We evaluated the DeltaFEV(1) after IFN therapy during the 3-year follow-up period in the 8 IFN responders and 13 IFN nonresponders. DeltaFEV(1) in the IFN nonresponders did not significantly change during the 3-year follow-up period (before, 65.5 mL/yr [SD, 23.5]; after, 66.1 mL/yr [SD, 24.0]). However, DeltaFEV(1) in the IFN responders significantly decreased (before, 68.4 mL/yr [SD, 26.2]; after, 57.3 mL/yr [SD, 23.6], p = 0.0116).


CONCLUSIONS
Our findings suggest that chronic HCV infection might accelerate decline in lung function in patients who already have COPD.
Kanazawa
Hiroshi
H
Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan. kanazawa-h@med.osaka-cu.ac.jp
Hirata
Kazuto
K
Yoshikawa
Junichi
J
D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000187:drug effects / Q000502:physiology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011653:Pulmonary Diffusing Capacity / Q000187:drug effects / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome
D016898:Interferon-alpha