Outcome of sustained virological responders with histologically advanced chronic hepatitis C
dc.contributor.author | Morgan, Timothy R. | en_US |
dc.contributor.author | Ghany, Marc G. | en_US |
dc.contributor.author | Kim, Hae-Young | en_US |
dc.contributor.author | Snow, Kristin K. | en_US |
dc.contributor.author | Shiffman, Mitchell L. | en_US |
dc.contributor.author | De Santo, Jennifer L. | en_US |
dc.contributor.author | Lee, William M. | en_US |
dc.contributor.author | Di Bisceglie, Adrian M. | en_US |
dc.contributor.author | Bonkovsky, Herbert L. | en_US |
dc.contributor.author | Dienstag, Jules L. | en_US |
dc.contributor.author | Morishima, Chihiro | en_US |
dc.contributor.author | Lindsay, Karen L. | en_US |
dc.contributor.author | Lok, Anna Suk-Fong | en_US |
dc.date.accessioned | 2010-10-06T14:53:59Z | |
dc.date.available | 2011-03-01T16:26:41Z | en_US |
dc.date.issued | 2010-09 | en_US |
dc.identifier.citation | Morgan, Timothy R.; Ghany, Marc G.; Kim, Hae-Young; Snow, Kristin K.; Shiffman, Mitchell L.; De Santo, Jennifer L.; Lee, William M.; Di Bisceglie, Adrian M.; Bonkovsky, Herbert L.; Dienstag, Jules L.; Morishima, Chihiro; Lindsay, Karen L.; Lok, Anna S. F. (2010). "Outcome of sustained virological responders with histologically advanced chronic hepatitis C." Hepatology 52(3): 833-844. <http://hdl.handle.net/2027.42/78047> | en_US |
dc.identifier.issn | 0270-9139 | en_US |
dc.identifier.issn | 1527-3350 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/78047 | |
dc.description.abstract | Retrospective studies suggest that subjects with chronic hepatitis C and advanced fibrosis who achieve a sustained virological response (SVR) have a lower risk of hepatic decompensation and hepatocellular carcinoma (HCC). In this prospective analysis, we compared the rate of death from any cause or liver transplantation, and of liver-related morbidity and mortality, after antiviral therapy among patients who achieved SVR, virologic nonresponders (NR), and those with initial viral clearance but subsequent breakthrough or relapse (BT/R) in the HALT-C (Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis) Trial. Laboratory and/or clinical outcome data were available for 140 of the 180 patients who achieved SVR. Patients with nonresponse (NR; n = 309) or who experienced breakthrough or relapse (BT/R; n = 77) were evaluated every 3 months for 3.5 years and then every 6 months thereafter. Outcomes included death, liver-related death, liver transplantation, decompensated liver disease, and HCC. Median follow-up for the SVR, BT/R, and NR groups of patients was 86, 85, and 79 months, respectively. At 7.5 years, the adjusted cumulative rate of death/liver transplantation and of liver-related morbidity/mortality in the SVR group (2.2% and 2.7%, respectively) was significantly lower than that of the NR group (21.3% and 27.2%, P < 0.001 for both) but not the BT/R group (4.4% and 8.7%). The adjusted hazard ratio (HR) for time to death/liver transplantation (HR = 0.17, 95% confidence interval [CI] = 0.06-0.46) or development of liver-related morbidity/mortality (HR = 0.15, 95% CI = 0.06-0.38) or HCC (HR = 0.19, 95% CI = 0.04-0.80) was significant for SVR compared to NR. Laboratory tests related to liver disease severity improved following SVR. Conclusion: Patients with advanced chronic hepatitis C who achieved SVR had a marked reduction in death/liver transplantation, and in liver-related morbidity/mortality, although they remain at risk for HCC. (H EPATOLOGY 2010;) | en_US |
dc.format.extent | 599987 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Hepatology | en_US |
dc.title | Outcome of sustained virological responders with histologically advanced chronic hepatitis C | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI | en_US |
dc.contributor.affiliationother | Division of Gastroenterology, University of California Irvine, Irvine, CA ; Gastroenterology Service, Veterans Affairs Long Beach Healthcare System, Long Beach, CA ; fax: 562-826-5436 ; VA Long Beach Healthcare System–11 (GI), 5901 East Seventh Street, Long Beach, CA 90822 | en_US |
dc.contributor.affiliationother | Liver Diseases Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD | en_US |
dc.contributor.affiliationother | New England Research Institutes, Watertown, MA | en_US |
dc.contributor.affiliationother | New England Research Institutes, Watertown, MA | en_US |
dc.contributor.affiliationother | Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA | en_US |
dc.contributor.affiliationother | Division of Gastroenterology and Hepatology, University of Colorado at Denver and Health Sciences Center, Denver, CO | en_US |
dc.contributor.affiliationother | Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX | en_US |
dc.contributor.affiliationother | Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO | en_US |
dc.contributor.affiliationother | Departments of Medicine and Molecular and Structural Biology and The Liver-Biliary-Pancreatic Center, University of Connecticut Health Center, Farmington, CT | en_US |
dc.contributor.affiliationother | Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, and the Department of Medicine, Harvard Medical School, Boston, MA | en_US |
dc.contributor.affiliationother | Division of Virology, Department of Laboratory Medicine, University of Washington, Seattle, WA | en_US |
dc.contributor.affiliationother | Division of Gastrointestinal and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA | en_US |
dc.identifier.pmid | 20564351 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/78047/1/23744_ftp.pdf | |
dc.identifier.doi | 10.1002/hep.23744 | en_US |
dc.identifier.source | Hepatology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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