Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients

Ching Sheng Hsu, Chun Jen Huang, Jia Horng Kao, Hans Hsienhong Lin, You Chen Chao, Yen Chun Fan, Pei Shan Tsai

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background:Interferon-based therapy (IBT) has been the standard of care for hepatitis C virus (HCV) infection. However, conflicting results exist regarding the effects of IBT on risk of developing hepatocellular carcinoma (HCC) and cirrhosis-associated complications, and most included highly selected patients.Methods:This 8-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 (>23.7 million). Patients with newly detected HCV infections (n = 11,264) were classified based on treatment and clinical outcomes. IBTs were defined as regimens that included interferon- alfa, pegylated interferon- alfa -2a, or pegylated interferon- alfa -2b for at least 3 months. The Cox proportional hazards models were used to estimate the hazard ratio (HR) and associated confidence interval (CI) of HCC and cirrhosis-associated complications for IBT.Results:The 8-year incidence rate for HCC was 3.9% among patients who received IBT and 5.6% among those who did not. The HCC-free survival rate was significantly higher among patients receiving IBT during the 8-year period than their counterpart (adjusted HR, 0.50; 95% CI, 0.31-0.81; P =. 004). Similarly, the event-free survival rates for esophageal variceal bleeding (adjusted HR, 0.45; 95% CI, 0.22-0.91; P =. 026), hepatic encephalopathy (adjusted HR, 0.38; 95% CI, 0.21-0.69; P =. 001), ascites (adjusted HR, 0.28; 95% CI, 0.14-0.57; P

Original languageEnglish
Article numbere70458
JournalPLoS One
Volume8
Issue number7
DOIs
Publication statusPublished - Jul 23 2013

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chronic hepatitis C
Chronic Hepatitis C
interferons
hepatoma
interferon-alpha
Interferons
confidence interval
Hepatocellular Carcinoma
Hazards
Fibrosis
Confidence Intervals
therapeutics
health insurance
Hepatitis C virus
Health insurance
Virus Diseases
Interferon-alpha
Hepacivirus
Viruses
Survival Rate

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients. / Hsu, Ching Sheng; Huang, Chun Jen; Kao, Jia Horng; Lin, Hans Hsienhong; Chao, You Chen; Fan, Yen Chun; Tsai, Pei Shan.

In: PLoS One, Vol. 8, No. 7, e70458, 23.07.2013.

Research output: Contribution to journalArticle

Hsu, Ching Sheng ; Huang, Chun Jen ; Kao, Jia Horng ; Lin, Hans Hsienhong ; Chao, You Chen ; Fan, Yen Chun ; Tsai, Pei Shan. / Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients. In: PLoS One. 2013 ; Vol. 8, No. 7.
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title = "Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients",
abstract = "Background:Interferon-based therapy (IBT) has been the standard of care for hepatitis C virus (HCV) infection. However, conflicting results exist regarding the effects of IBT on risk of developing hepatocellular carcinoma (HCC) and cirrhosis-associated complications, and most included highly selected patients.Methods:This 8-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 (>23.7 million). Patients with newly detected HCV infections (n = 11,264) were classified based on treatment and clinical outcomes. IBTs were defined as regimens that included interferon- alfa, pegylated interferon- alfa -2a, or pegylated interferon- alfa -2b for at least 3 months. The Cox proportional hazards models were used to estimate the hazard ratio (HR) and associated confidence interval (CI) of HCC and cirrhosis-associated complications for IBT.Results:The 8-year incidence rate for HCC was 3.9{\%} among patients who received IBT and 5.6{\%} among those who did not. The HCC-free survival rate was significantly higher among patients receiving IBT during the 8-year period than their counterpart (adjusted HR, 0.50; 95{\%} CI, 0.31-0.81; P =. 004). Similarly, the event-free survival rates for esophageal variceal bleeding (adjusted HR, 0.45; 95{\%} CI, 0.22-0.91; P =. 026), hepatic encephalopathy (adjusted HR, 0.38; 95{\%} CI, 0.21-0.69; P =. 001), ascites (adjusted HR, 0.28; 95{\%} CI, 0.14-0.57; P",
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AU - Hsu, Ching Sheng

AU - Huang, Chun Jen

AU - Kao, Jia Horng

AU - Lin, Hans Hsienhong

AU - Chao, You Chen

AU - Fan, Yen Chun

AU - Tsai, Pei Shan

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AB - Background:Interferon-based therapy (IBT) has been the standard of care for hepatitis C virus (HCV) infection. However, conflicting results exist regarding the effects of IBT on risk of developing hepatocellular carcinoma (HCC) and cirrhosis-associated complications, and most included highly selected patients.Methods:This 8-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 (>23.7 million). Patients with newly detected HCV infections (n = 11,264) were classified based on treatment and clinical outcomes. IBTs were defined as regimens that included interferon- alfa, pegylated interferon- alfa -2a, or pegylated interferon- alfa -2b for at least 3 months. The Cox proportional hazards models were used to estimate the hazard ratio (HR) and associated confidence interval (CI) of HCC and cirrhosis-associated complications for IBT.Results:The 8-year incidence rate for HCC was 3.9% among patients who received IBT and 5.6% among those who did not. The HCC-free survival rate was significantly higher among patients receiving IBT during the 8-year period than their counterpart (adjusted HR, 0.50; 95% CI, 0.31-0.81; P =. 004). Similarly, the event-free survival rates for esophageal variceal bleeding (adjusted HR, 0.45; 95% CI, 0.22-0.91; P =. 026), hepatic encephalopathy (adjusted HR, 0.38; 95% CI, 0.21-0.69; P =. 001), ascites (adjusted HR, 0.28; 95% CI, 0.14-0.57; P

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