Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C
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 studie...
| Autores principales: | , , , , , , , |
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| Formato: | Artículo |
| Lenguaje: | inglés |
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Ediciones Medicina y Cultura
2015
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| Materias: | |
| Acceso en línea: | http://eprints.uanl.mx/25644/1/25644.pdf |
| _version_ | 1824420266482073600 |
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| author | Martínez Macías, Roberto F. Cordero Pérez, Paula Juárez Rodríguez, Omar A. Chen López, Carlos Y. Martínez Carrillo, Francisco M. Alarcón Galván, Gabriela Mercado Hernández, Roberto Muñoz Espinosa, Linda Elsa |
| author_facet | Martínez Macías, Roberto F. Cordero Pérez, Paula Juárez Rodríguez, Omar A. Chen López, Carlos Y. Martínez Carrillo, Francisco M. Alarcón Galván, Gabriela Mercado Hernández, Roberto Muñoz Espinosa, Linda Elsa |
| author_sort | Martínez Macías, Roberto F. |
| collection | Repositorio Institucional |
| description | 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 (log-rank, 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. |
| format | Article |
| id | eprints-25644 |
| institution | UANL |
| language | English |
| publishDate | 2015 |
| publisher | Ediciones Medicina y Cultura |
| record_format | eprints |
| spelling | eprints-256442024-03-05T20:43:38Z http://eprints.uanl.mx/25644/ Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C Martínez Macías, Roberto F. Cordero Pérez, Paula Juárez Rodríguez, Omar A. Chen López, Carlos Y. Martínez Carrillo, Francisco M. Alarcón Galván, Gabriela Mercado Hernández, Roberto Muñoz Espinosa, Linda Elsa RC Medicina Interna, Psiquiatría, Neurología 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 (log-rank, 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. Ediciones Medicina y Cultura 2015 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/25644/1/25644.pdf http://eprints.uanl.mx/25644/1.haspreviewThumbnailVersion/25644.pdf Martínez Macías, Roberto F. y Cordero Pérez, Paula y Juárez Rodríguez, Omar A. y Chen López, Carlos Y. y Martínez Carrillo, Francisco M. y Alarcón Galván, Gabriela y Mercado Hernández, Roberto y Muñoz Espinosa, Linda Elsa (2015) Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C. Annals of Hepatology, 14 (1). pp. 36-45. ISSN 16652681 http://doi.org/10.1016/S1665-2681(19)30799-9 doi:10.1016/S1665-2681(19)30799-9 |
| spellingShingle | RC Medicina Interna, Psiquiatría, Neurología Martínez Macías, Roberto F. Cordero Pérez, Paula Juárez Rodríguez, Omar A. Chen López, Carlos Y. Martínez Carrillo, Francisco M. Alarcón Galván, Gabriela Mercado Hernández, Roberto Muñoz Espinosa, Linda Elsa Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C |
| title_full | Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C |
| title_fullStr | Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C |
| title_full_unstemmed | Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C |
| title_short | Interferon-based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis C |
| title_sort | interferon based therapy delays but metabolic comorbidity accelerates progression of chronic hepatitis c |
| topic | RC Medicina Interna, Psiquiatría, Neurología |
| url | http://eprints.uanl.mx/25644/1/25644.pdf |
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