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Open Access Research article

Effects and Outcomes of Interferon Treatment in Japanese Hepatitis C Patients

Kazumi Yamasaki16*, Mayumi Tomohiro2, Yumiko Nagao3, Michio Sata34, Toshiaki Shimoda2, Kazuhiro Hirase2 and Satoshi Shirahama5

Author Affiliations

1 Narao Medical Center, Shinkamigoto, Japan

2 Kamigoto Hospital, Shinkamigoto, Japan

3 Department of Digestive Disease Information & Research, Kurume University School of Medicine, Kurume, Fukuoka, Japan

4 Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan

5 Arikawa Medical Center, Shinkamigoto, Japan

6 Narao Medical Center, 712-3 Narao-go Shinkamigoto-cho Minamimatsuura-gun, Nagasaki, Japan

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BMC Gastroenterology 2012, 12:139  doi:10.1186/1471-230X-12-139

Published: 12 October 2012

Abstract

Background

No study has compared the long-term prognoses of hepatitis C patients with hepatitis C virus (HCV) antibody-negative individuals and investigated the effects of interferon (IFN) treatment. To clarify the long-term prognosis of HCV-positive residents of an isolated Japanese island and prospectively investigate the effects of IFN treatment in comparison with the HCV-negative general population.

Methods

HCV antibody was positive in 1,343 (7.6%) of the 17,712 individuals screened. 792 HCV RNA-positive, HBsAg-negative subjects were enrolled. 1,584 HCV antibody-negative, HBsAg-negative general residents were sex- and age-matched to the 792 subjects. A total of 154 <70-year-old patients without liver cirrhosis (LC) or hepatocellular carcinoma (HCC) underwent IFN treatment. The survival rate with all-cause death as the endpoint was determined and causes of death were compared.

Results

The 10- and 20-year survival rates of the hepatitis C and general resident groups were 65.4% and 87.8%, and 40.8% and 62.5%, respectively (p < 0.001; hazard risk ratio, 0.444; 95% confidence interval (CI): 0.389–0.507). There were 167 liver disease-related deaths and 223 deaths from other causes in the hepatitis C group, and 7 and 451, respectively, in the general resident group. Liver disease-related death accounted for 43.8% and 1.5% of deaths in the hepatitis C and general resident groups (p < 0.0001). The cumulative survival rate of the hepatitis C patients without IFN (n = 328) was significantly lower than the gender- and age-matched general resident group (n = 656) (p < 0.0001) but there was no significant difference between the IFN-treated (n = 154) and general resident groups (n = 308).

Conclusions

In the hepatitis C group, the proportion of liver disease-related death was markedly higher, and the survival rate lower, than the general resident group. Introduction of IFN treatment in <70-year-old patients with hepatitis C without LC or HCC improved the survival rate to a level comparable to that of the general residents.

Keywords:
Hepatitis C virus; Hepatocellular carcinoma; Prospective cohort study; Interferon; Life expectancy