title: The clinical outcomes of chronic hepatitis C in South Korea: A prospective, multicenter cohort study.
abstract: This prospective cohort study aimed to elucidate the clinical outcome and its related factors of chronic hepatitis C in a hepatitis B-dominant Asian region.From January 2007 to October 2012, 382 patients with chronic hepatitis C without liver cirrhosis were prospectively enrolled at 6 university hospitals, and regularly followed until Apr 2014 to identify the development of liver cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC), and overall survival.During the median follow-up of 39.0 months (range 18.0-81.0 months), liver cirrhosis, hepatic decompensation, and HCC developed in 42 patients (11.0%), 4 patients (1.0%), and 12 patients (3.1%), respectively. The cumulative probability of development of cirrhosis at 3 years and at 5 years was 9.6% and 16.7%, respectively. That of HCC at 3 and 5 years was 1.6% and 4.5%, respectively. The 3-year and 5-year overall survival rate was 99.7% and 96.0%, respectively. Pegylated interferon-based antiviral therapy was undertaken in 237 patients (62.0%) with a sustained virologic response (SVR) rate of 74.3%. The factors related to the overall clinical outcomes were age ≥55 years (HR 2.924, P = 0.016), platelet counts <150  × 10/L (HR 3.195, P = 0.007), and the achievement of SVR (HR 0.254, P = 0.002).The clinical outcomes of this Korean chronic hepatitis C cohort were modest with minimal mortality, but significant disease progression occurred in the patients with old age, low platelet, and non-SVR after interferon-based antiviral treatment or no treatment, suggesting priority for direct acting antiviral therapy.
authors: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan Departement of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeonju Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun Department of Internal Medicine, The Catholic University of Korea, Seoul Saint Mary's Hospital Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: Kyeong Sam
authors: KS
authors: Ok
authors: Sook-Hyang
authors: SH
authors: Jeong
authors: Eun Sun
authors: ES
authors: Jang
authors: Young Seok
authors: YS
authors: Kim
authors: Youn Jae
authors: YJ
authors: Lee
authors: In Hee
authors: IH
authors: Kim
authors: Sung Bum
authors: SB
authors: Cho
authors: Si Hyun
authors: SH
authors: Bae
authors: Han Chu
authors: HC
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000821:virology; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D015994:Incidence; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D015996:Survival Rate; D000072230:Sustained Virologic Response
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D012254:Ribavirin