Favorable Prognosis of Chronic Hepatitis C After Interferon Therapy by Long–Term Cohort Study

Abstract

The prognosis of patients with chronic hepatitis C after interferon (IFN) therapy is still poorly defined. The present study evaluated the effect of IFN therapy on survival in a cohort of such patients. The study included 459 patients with biopsy–proven C–viral chronic liver disease who were followed for 8.2 ± 2.9 years (range, 7–183 months). Survival status was examined by medical records or direct questionnaires. Fifteen (14%) of 104 IFN–untreated patients and 33 (9%) of 355 patients treated with IFN died during follow–up. Among the treated patients, 4 (3%) of 116 with sustained virologic response and 29 (12%) of 239 without sustained virologic response died. Liver–related death was shown in 32 (67%) patients, and hepatocellular carcinoma (HCC) caused 25 (52%) of the 48 deaths. Multivariate Cox proportional regression analysis revealed that IFN treatment decreased the risk ratio for overall death to 0.521 (confidence interval [CI]: 0.263–1.034) and for liver–related death to 0.208 (CI: 0.088–0.495) compared with untreated patients, and sustained virologic response showed a decrease in the risk ratio for overall death to 0.219 (CI: 0.068–0.710) and for liver–related death to 0.030 (CI: 0.003–0.267). IFN treatment showed no association with liver–unrelated death. Furthermore, the standardized mortality ratios for all causes of death and liver–related death were reduced in IFN–treated patients compared with untreated patients (1.4 vs. 2.0 for total death and 7.9 vs. 19.7 for liver–related death). In conclusion, the present data suggest that IFN therapy has a long–term clinical benefit for patients with chronic hepatitis C patients by reducing liver–related death, especially in patients with sustained virologic response.