Interferon therapy for aged patients with chronic hepatitis C: improved survival in patients exhibiting a biochemical response
Interferon therapy for aged patients with chronic hepatitis C: improved survival in patients exhibiting a biochemical response
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DOI：
10.1007/s00535-004-1448-0
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发表时间：
2004-11
影响因子：
6.3
通讯作者：
Y. Imai;A. Kasahara;Hideo Tanaka;T. Okanoue;N. Hiramatsu;H. Tsubouchi;K. Yoshioka;S. Kawata;E. Tanaka;K. Hino;K. Hayashi;S. Tamura;Y. Itoh;Y. Sasaki;K. Kiyosawa;S. Kakumu;K. Okita;N. Hayashi
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文献类型：
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作者：
Y. Imai;A. Kasahara;Hideo Tanaka;T. Okanoue;N. Hiramatsu;H. Tsubouchi;K. Yoshioka;S. Kawata;E. Tanaka;K. Hino;K. Hayashi;S. Tamura;Y. Itoh;Y. Sasaki;K. Kiyosawa;S. Kakumu;K. Okita;N. Hayashi
背景在日本，慢性丙型肝炎患者一般都是高龄患者。本研究旨在探讨干扰素治疗对60岁以上慢性丙型肝炎患者病死率的影响。方法经组织学证实的慢性丙型肝炎患者700例，其中干扰素治疗组649例，对照组58例。结果干扰素组和对照组的平均随访期分别为5.7年和6.7年。随访期间，对照组13例死亡(7例死于肝脏相关疾病)，干扰素组42例死亡(29例死于肝脏相关疾病)。对照组和干扰素组总死亡的SMR分别为1.40(95%CI，0.76~2.45)和0.73(95%CI，0.52~0.98)，肝脏相关死亡的SMR分别为10.70(95%CI，4.29~22.05)和5.05(95%CI，3.38~7.26)。与对照组相比，干扰素组的持续和瞬时生化应答(SMR，0.53；95%CI，0.01~2.97和SMR，3.25；95%CI，0.87~8.32)显示出较低的肝脏相关死亡率。在持续病毒学应答的患者中，与肝脏相关的死亡率也非常低(SMR，0.65；95%CI，0.01-3.61)。与对照组相比，持续和短暂生化应答者发生肝脏相关死亡的风险也较低(调整后的风险比分别为0.10[95%CI，0.01~0.95]和0.50[95%CI，0.11~2.21])。结论干扰素治疗可降低60岁以上慢性丙型肝炎患者的肝脏相关死亡率，尤其是表现为生化应答和持续病毒学应答的患者。
BackgroundIn 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.MethodsSeven-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.ResultsMean 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).ConclusionsThese 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.