Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C

Roberto F. Martínez-Macías, Paula Cordero-Pérez, Omar A. Juárez-Rodríguez, Carlos Y. Chen-López, Francisco M. Martínez-Carrillo, Gabriela Alarcón-Galván, Roberto Mercado-Hernández, Linda E. Muñoz-Espinosa

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Abstract

© 2014 Annals of Hepatology. All rights reserved. Background: We compared mortality and complications of chronic hepatitis C between treated and untreated Mexican patients after long-term follow-up. We used a time-to-event analysis and identified the prognostic factors. Material and methods: Seventy-four patients with chronic hepatitis C were studied. They were ≥ 18 years of age and had a molecular diagnosis of chronic hepatitis C and ≥ 6 months of follow- up. Patients with neoplasia or those infected with human immunodeficiency virus or hepatitis B Virus were excluded. Kaplan-Meier analysis, log-rank test, annualized incidence per 100 person-years, and stepwise discriminant analysis were used to analyse mortality and complications. Results: The end-point of annualized incidence was lowest in sustained virological responders, intermediate in non-responders, and highest in untreated patients. The absence of treatment impacted adversely on cirrhosis development and the occurrence of portal hypertension and hepatic decompensation/hepatocellular carcinoma (logrank, p < 0.05). Diabetes impacted adversely on liver-related death/liver transplantation among untreated patients. Stepwise discriminant analysis showed that diabetes, high blood pressure, and no retreatment predicted cirrhosis development (eigenvalue ≥ 0.8; p < 0.05). A MELD score ≥ 18 and age ≥ 50 years predicted hepatic decompensation/hepatocellular carcinoma (eigenvalue < 0.8; p < 0.05). APRI ≥ 1.5 predicted mortality/liver transplantation and liver-related death/liver transplantation (eigenvalue < 0.8; p < 0.05). Conclusions: This is the first long-term study of chronic hepatitis C among Mexican patients. Treated patients showed less progression of liver disease. Treated patients showed less progression of liver disease; and older patients, those with metabolic comorbidities, with MELD score ≥ 18 and APRI ≥ 1.5 exhibited adverse effects.
Original languageEnglish
Pages (from-to)36-45
Number of pages10
JournalAnnals of Hepatology
Publication statusPublished - 1 Jan 2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology

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    Martínez-Macías, R. F., Cordero-Pérez, P., Juárez-Rodríguez, O. A., Chen-López, C. Y., Martínez-Carrillo, F. M., Alarcón-Galván, G., Mercado-Hernández, R., & Muñoz-Espinosa, L. E. (2015). Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C. Annals of Hepatology, 36-45. https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84918778244&origin=inward