title: Viral eradication reduces all-cause mortality, including non-liver-related disease, in patients with progressive hepatitis C virus-related fibrosis.
abstract: OBJECTIVE
  Eradication of hepatitis C virus (HCV) with interferon (IFN)-based therapy has been reported to reduce all-cause mortality in patients with chronic HCV infection. However, the impact of HCV eradication on non-liver-related mortality and causes of death has not been sufficiently investigated in patients with progressive HCV-related fibrosis.
  
  
  METHODS
  We enrolled 784 chronic HCV patients with progressive liver fibrosis (aspartate aminotransferase to platelet ratio index >1). Cause of death, incidence of hepatocellular carcinoma, and all-cause mortality including non-liver-related mortality were analyzed.
  
  
  RESULTS
  Of these 784 patients, 170 achieved sustained virological response (SVR) (eradication of HCV) with IFN-based therapy (IFN-SVR), and 614 did not receive IFN-based therapy (non-IFN patients, chronic HCV infection). The median follow-up duration was 10.3 years. Two hundred seventy-three patients died during follow-up (liver-related death, n = 171; non-liver-related death, n = 102). The mortality rate from non-liver-related disease was 63.6% (7/11) in IFN-SVR patients and 36.3% (95/262) in non-IFN patients, respectively. In multivariate analysis, the eradication of HCV associated with not only hepatocellular carcinoma incidence (hazard ratio (HR), 0.162; 95% confidence interval (CI), 0.092-0.284), and all-cause mortality (HR, 0.094; 95% CI, 0.047-0.187), but non-liver-related mortality (HR, 0.286; 95% CI, 0.127-0.644) as well.
  
  
  CONCLUSIONS
  Eradication of HCV reduced both liver-related and non-liver-related mortality in patients with progressive HCV-related fibrosis.
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Toshifumi
authors: T
authors: Tada
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Takashi
authors: T
authors: Kumada
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Hidenori
authors: H
authors: Toyoda
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Seiki
authors: S
authors: Kiriyama
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Makoto
authors: M
authors: Tanikawa
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Yasuhiro
authors: Y
authors: Hisanaga
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Akira
authors: A
authors: Kanamori
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Shusuke
authors: S
authors: Kitabatake
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Tsuyoki
authors: T
authors: Yama
authors: Department of Epidemiology, Infectious Disease Control, and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
authors: Junko
authors: J
authors: Tanaka
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000517:prevention & control; D002423:Cause of Death; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000401:mortality* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000209:etiology / Q000401:mortality*; D008113:Liver Neoplasms / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis
chemical_list: D000998:Antiviral Agents; D007372:Interferons
keywords: causes of death; eradication of HCV; hepatitis C; non-liver-related mortality; progressive liver fibrosis