title: Interferon-Based Treatment of Hepatitis C Virus Infection Reduces All-Cause Mortality in Patients With End-Stage Renal Disease: An 8-Year Nationwide Cohort Study in Taiwan.
abstract: The long-term survival of end-stage renal disease (ESRD) patients with hepatitis C virus (HCV) infection who received interferon treatment has not been extensively evaluated.The HCV cohort was the ESRD patients with de novo HCV infection from 2004 to 2011; they were classified into treated and untreated groups according to interferon therapy records. Patients aged <20 years and those with a history of hepatitis B, kidney transplantation, or cancer were excluded. The control cohort included ESRD patients without HCV infection matched 4:1 to the HCV cohort by age, sex, and year of ESRD registration. We followed up all study participants until kidney transplantation, death, or the end of 2011, whichever came first. We assessed risk of all-cause mortality by using the multivariate Cox proportional hazard model with time-dependent covariate.In the HCV cohort, 134 patients (6.01%) received interferon treatment. Compared with the uninfected control cohort, the treated group had a lower risk of death (hazard ratio 0.47, 95% confidence interval [CI] 0.22-0.99). The untreated group had a 2.62-fold higher risk (95% CI 1.24-5.55) of death compared with the treated group. For the HCV cohort without cirrhosis or hepatoma, the risk of death in the treated group was further markedly reduced (hazard ratio 0.17, 95% CI 0.04-0.68) compared with that in the control cohort.For ESRD patients with HCV infection, receiving interferon treatment is associated with a survival advantage. Such an advantage is more prominent in HCV patients without cirrhosis or hepatoma.
authors.affiliation: From the Department of Health Services Administration City (Y-HH, W-CT, C-CH), China Medical University, Taichung; Department of Internal Medicine (Y-HH, P-HH), Division of Nephrology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City; Department of Nursing (Y-HH), Min-Hwei Junior College of Health Care Management, Tainan City; Department of Applied Life Science and Health (P-HH), Chia-Nan University of Pharmacy and Science, Tainan; Management Office for Health Data (C-HM), China Medical University Hospital; College of Medicine (C-HM), China Medical University, Taichung City; Institute of Population Health Sciences (C-CH), National Health Research Institutes, Zhunan, Miaoli County; Graduate Institute of Clinical Medical Science and School of Medicine (C-HK), College of Medicine, China Medical University; and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung City, Taiwan.
authors.forename: Yueh-Han
authors.initials: YH
authors.lastname: Hsu
authors.forename: Peir-Haur
authors.initials: PH
authors.lastname: Hung
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsu
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents; D007372:Interferons