Effects and outcomes of interferon treatment in Japanese hepatitis C patients.
BACKGROUND
No study has compared the long-term prognoses of hepatitis C patients with hepatitis C virus (HCV) antibody-negative individuals and investigated the effects of interferon (IFN) treatment. To clarify the long-term prognosis of HCV-positive residents of an isolated Japanese island and prospectively investigate the effects of IFN treatment in comparison with the HCV-negative general population.


METHODS
HCV antibody was positive in 1,343 (7.6%) of the 17,712 individuals screened. 792 HCV RNA-positive, HBsAg-negative subjects were enrolled. 1,584 HCV antibody-negative, HBsAg-negative general residents were sex- and age-matched to the 792 subjects. A total of 154 <70-year-old patients without liver cirrhosis (LC) or hepatocellular carcinoma (HCC) underwent IFN treatment. The survival rate with all-cause death as the endpoint was determined and causes of death were compared.


RESULTS
The 10- and 20-year survival rates of the hepatitis C and general resident groups were 65.4% and 87.8%, and 40.8% and 62.5%, respectively (p < 0.001; hazard risk ratio, 0.444; 95% confidence interval (CI): 0.389-0.507). There were 167 liver disease-related deaths and 223 deaths from other causes in the hepatitis C group, and 7 and 451, respectively, in the general resident group. Liver disease-related death accounted for 43.8% and 1.5% of deaths in the hepatitis C and general resident groups (p < 0.0001). The cumulative survival rate of the hepatitis C patients without IFN (n = 328) was significantly lower than the gender- and age-matched general resident group (n = 656) (p < 0.0001) but there was no significant difference between the IFN-treated (n = 154) and general resident groups (n = 308).


CONCLUSIONS
In the hepatitis C group, the proportion of liver disease-related death was markedly higher, and the survival rate lower, than the general resident group. Introduction of IFN treatment in <70-year-old patients with hepatitis C without LC or HCC improved the survival rate to a level comparable to that of the general residents.
Narao Medical Center, Shinkamigoto, Japan. rsr03768@nifty.com
Kazumi
K
Yamasaki
Mayumi
M
Tomohiro
Yumiko
Y
Nagao
Michio
M
Sata
Toshiaki
T
Shimoda
Kazuhiro
K
Hirase
Satoshi
S
Shirahama
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D044466:Asian People; D002423:Cause of Death; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D018937:Hepatitis C Antibodies / Q000097:blood / Q000276:immunology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D016899:Interferon-beta / Q000627:therapeutic use*; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012254:Ribavirin / Q000627:therapeutic use; D015996:Survival Rate; D016896:Treatment Outcome
D000998:Antiviral Agents; D018937:Hepatitis C Antibodies; D016898:Interferon-alpha; D012254:Ribavirin; D016899:Interferon-beta