title: Interferon therapy for aged patients with chronic hepatitis C: improved survival in patients exhibiting a biochemical response.
abstract: BACKGROUND
  In Japan, generally, patients with chronic hepatitis C are aged. The aim of this study was to investigate the effect of interferon (IFN) therapy on the mortality of chronic hepatitis C patients over age 60.
  
  
  METHODS
  Seven-hundred and seven patients with histologically proven chronic hepatitis C were enrolled in this study; 649 received IFN therapy (IFN group) and 58 did not (control group). The standardized mortality ratio (SMR) and Cox proportional hazard regression analysis were used to evaluate the effect of IFN on the survival of the patients.
  
  
  RESULTS
  Mean follow-up periods in the IFN and control groups were 5.7 and 6.7 years, respectively. During follow-up, 13 patients in the control group died (7 of liver-related diseases) and 42 in the IFN group died (29 of liver-related diseases). The SMRs of the control and IFN groups were 1.40 (95% confidence interval [CI], 0.76-2.45) and 0.73 (95% CI, 0.52-0.98) for overall death, and 10.70 (95% CI, 4.29-22.05) and 5.05 (95% CI, 3.38-7.26) for liver-related death, respectively. Sustained and transient biochemical responders in the IFN group (SMR, 0.53; 95% CI, 0.01-2.97 and SMR, 3.25; 95% CI, 0.87-8.32, respectively) showed lower liver-related mortality compared with the control group. In patients with sustained virological response, liver-related mortality was also very low (SMR, 0.65; 95% CI, 0.01-3.61). The risk for liver-related death of sustained and transient biochemical responders was also low compared with that of the control group (adjusted risk ratios 0.10 [95% CI, 0.01-0.95] and 0.50 [95% CI, 0.11-2.21], respectively).
  
  
  CONCLUSIONS
  These results suggest that IFN treatment could reduce liver-related mortality in chronic hepatitis C patients over age 60, notably in patients showing a biochemical response and in those showing a sustained virological response.
authors.affiliation: Department of Internal Medicine, Ikeda Municipal Hospital, 3-1-18 Johnan, 563-8510, Ikeda, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Imai
authors.forename: Akinori
authors.initials: A
authors.lastname: Kasahara
authors.forename: Hideo
authors.initials: H
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiramatsu
authors.forename: Hirohito
authors.initials: H
authors.lastname: Tsubouchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Sumio
authors.initials: S
authors.lastname: Kawata
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hino
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Shinji
authors.initials: S
authors.lastname: Tamura
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Itoh
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Kendo
authors.initials: K
authors.lastname: Kiyosawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kakumu
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000998:Antiviral Agents; D007372:Interferons; D000410:Alanine Transaminase