Excess mortality in patients with advanced chronic hepatitis C treated with long-term peginterferon
Year: 2011
Type: article
Abstract: UNLABELLED: Chronic hepatitis C virus infection can cause chronic liver disease, cirrhosis and liver cancer. The Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial was a prospective, randomized controlled study of long-term, low-dose peginterferon therapy in patients with advanced chronic hepatitis C who failed to respond to a previous course of optimal antiviral therapy. The aim of this follow-up analysis is to describe the frequency and causes of death among this cohort of patients. Deaths occurring during and after the HALT-C Trial were reviewed by a committee of investigators to determine the cause of death and to categorize each death as liver- or nonliver-related and as related or not to complications of peginterferon. Rates of liver transplantation were also assessed. Over a median of 5.7 years, 122 deaths occurred among 1,050 randomized patients (12%), of which 76 were considered liver-related (62%) and 46 nonliver-related (38%); 74 patients (7%) underwent liver transplantation. At 7 years the cumulative mortality rate was higher in the treatment compared to the control group (20% versus 15%, P = 0.049); the primary difference in mortality was in patients in the fibrosis compared to the cirrhosis stratum (14% versus 7%, P = 0.01); comparable differences were observed when liver transplantation was included. Excess mortality, emerging after 3 years of treatment, was related largely to nonliver-related death; liver-related mortality was similar in the treatment and control groups. No specific cause of death accounted for the excess mortality and only one death was suspected to be a direct complication of peginterferon. CONCLUSION: Long-term maintenance peginterferon in patients with advanced chronic hepatitis C is associated with an excess overall mortality, which was primarily due to nonliver-related causes among patients with bridging fibrosis.
Source: Hepatology
DOI: 10.1002/hep.24169
Institutions: Saint Louis University, New England Research Institutes, Harvard University, Massachusetts General Hospital, Bon Secours Health System, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Carolinas Medical Center, UConn Health, University of Washington, Office of the Director, The University of Texas Southwestern Medical Center, University of Michigan, Michigan Medicine, University of California, Irvine, VA Long Beach Healthcare System
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Massachusetts General Hospital, University of Southern California, Harvard Catalyst, University of Connecticut, University of Washington, Virginia Commonwealth University, Saint Louis University, National Institutes of Health, Genentech, University of California, Irvine, University of Colorado Denver, National Cancer Institute, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Institute on Minority Health and Health Disparities
Awards: G1004247942, G1008791772, G1016094800, G1024134251, G1191793216, G1500039052, G1638345366, G1740463284, GENERAL CLINICAL RESEARCH CENTER, G1872674494, G1952602728, G220748524, G2383253098, G2496518617, G2527449299, General Clinical Research Center, G2718263081, G3277324657, G3350686849, Harvard Clinical and Translational Science Center (UL1), General Clinical Research Center, General Clinical Research Center, G3740841103, G420249297, G4310905822, G4627513917, Michigan Institute for Clinical and Health Research (MICHR) (UL1), North and Central Texas Clinical and Translational Science Initiative (UL1), G57319417, General Clinical Research Center, General Clinical Research Center, Hepatitis C Clinical Trial-Clinical Center, G6073674831, G635792350, G645260498, G6559552646, G6878061125, G6998970483, G7557510160, G769717368, General Clinical Research Center, G838905924, G848270291, G881343144, General Clinical Research Center, G9000328944, G937870883, Colorado Clinical and Translational Science Institute (UL1)
OpenAlex ID: W2166793194