Navigation Links
Increased mortality rates seen in chronic hepatitis C patients with pre-cirrhotic advanced fibrosis
Date:4/7/2011

A three-year follow-up study of patients in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) trial revealed that increased mortality among patients with advanced chronic hepatitis C who received long-term peginterferon therapy was attributed to non-liver related causes and occurred primarily in patients with bridging fibrosis. No pattern to this excess mortality was evident to researchers, but deaths were unrelated to the peginterferon treatment. Full findings are published in the April issue of Hepatology, a peer-reviewed journal of the American Association for the Study of Liver Diseases (AASLD).

Infection with hepatitis C virus (HCV) is the primary cause of chronic hepatitis in the U.S., and is a major cause of morbidity and mortality resulting from cirrhosis and hepatocellular carcinoma (HCC). According to the Centers for Disease Control and Prevention (CDC), 3.2 million American are infected with chronic HCV which accounts for up to 10,000 deaths annually in the U.S. The standard treatment for chronic HCV is a combination of pegylated interferon and ribavirina combination therapy which achieves sustained virological response rates of 40%-80% as reported by the CDC. Though antiviral therapy may decrease the rate of progression and death from chronic HCV, there is currently no beneficial therapy available for patients who fail to respond to standard treatment.

The initial HALT-C Triala randomized, controlled study of 1,050 chronic HCV patients with advanced fibrosis (n=622) or cirrhosis (n=428) who failed to achieve a sustained response from prior antiviral therapyevaluated the effects of low-dose maintenance therapy with peginterferon, compared to no therapy, in slowing disease progression and preventing end-stage liver disease, HCC, and death. The results from the randomized phase showed that long-term peginterferon treatment failed to produce a positive effect on clinical outcomes or death. Furthermore, the authors noted that excess mortality occurred in the treatment group among patients with advanced fibrosis without cirrhosis.

"We followed the trial participants for an additional three years to investigate whether the increased mortality persisted and to explore causes of death," said lead study author Adrian Di Bisceglie, MD, FACP, Chairman of the Department of Internal Medicine at Saint Louis University School of Medicine in Missouri. For the current analysis, a committee of investigators reviewed deaths occurring during and after the HALT-C Trial to determine the cause of death. The committee categorized each death as liver- or non-liver related, and whether or not the death was associated with complications of peginterferon.

Analysis showed that 18% of the trial participants died (122) or underwent liver transplantation (74) over a median of 5.7 years. Two thirds of the deaths (62%) were attributed to end-stage liver disease or HCC and the remaining deaths (38%) were attributed to non-liver-related causes. The cumulative seven-year mortality rate was 20% for patients in the treatment group compared to 15% in the non-treatment control. Researchers observed differences in mortality rates (by seven years) between the treatment and non-treatment groups which were statistically significant for patients with fibrosis (14% and 7%, respectively) compared to those with cirrhosis (28% and 26%, respectively).

Researchers noted that the increase in mortality for patients treated with peginterferon did not emerge until three years into treatment and continued for several years after treatment ceased. The excess mortality in the treatment group was mainly linked to non-liver-related causes. "No specific cause of death accounted for the excess mortality, but deaths were unrelated to direct effects of peginterferon treatment," concluded Dr. Di Bisceglie. Researchers could not identify an excess frequency of any single condition or disease category for cause of non-liver related deaths. Only one death was determined to be a probable result of complications from peginterferon therapy. "Our findings suggest that the long-term use of peginterferon should be evaluated cautiously and that attention to unrelated complications is warranted."


'/>"/>

Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Emergency department CT exams of children have increased substantially
2. Children of women who smoked during pregnancy at increased risk of becoming smokers
3. Traffic accidents linked to increased risk of chronic widespread pain
4. Gardening linked to increased vegetable consumption in older adults
5. Heavy drinking associated with increased risk of death from pancreatic cancer
6. Adults With HIV at Increased Risk of Bone Fractures, Study Finds
7. Acquisition of robotic technology leads to increased rates of prostate cancer surgery
8. Non-steroidal anti-inflammatory drugs linked to increased risk of erectile dysfunction
9. Multiple childbirth linked to increased risk of rare, aggressive triple-negative breast cancer
10. High Triglyceride Levels Linked to Increased Stroke Risk: Study
11. Cell-phone use not related to increased brain cancer risk
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was out ... family verbally and physically. , “When something upset him, he couldn’t control his emotions,” remembers ... would throw rocks at my other children and say he was going to kill them. ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. ... accelerated orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, ... and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic ...
(Date:6/24/2016)... ... ... People across the U.S. are sharpening their pencils and honing their writing ... which patients and their families pay tribute to a genetic counselor by nominating him ... Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. , In April, Genome ...
(Date:6/24/2016)... ... June 24, 2016 , ... Puradigm® & Innovative Solutions ... initiated cultivation and processing operations at its production facility, and opened its first ... is the manufacturer of a complete system of proactive air and surface purification ...
(Date:6/24/2016)... ... ... Venture Construction Group (VCG) sponsors Luke’s Wings 5th Annual ... Country Club at 1201 Rockville Pike, Rockville, Maryland, 20852. The event raised funds ... been wounded in battle and their families. Venture Construction Group is a 2016 Silver ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)...  VMS Rehab Systems, Inc. ( www.vmsrehabsystemsinc.com ) reported ... required to build a strong and stable market for ... on the OTC Markets-pink current trading platform. ... are seeing an anomaly in market trading activities that ... the Company, but shareholders and market players as well. ...
(Date:6/24/2016)... SAN FRANCISCO, Calif. , June 24, 2016 ... GBT ), a biopharmaceutical company developing novel therapeutics ... significant unmet needs, today announced the closing of ... shares of common stock, at the public offering ... shares in the offering were offered by GBT. ...
(Date:6/24/2016)... ALEXANDRIA, Va. , June 24, 2016 ... a set of recommendations that would allow ... information (HCEI) with entities that make formulary and coverage ... determine the "value" of new medicines. The ... that does not appear on the drug label, a ...
Breaking Medicine Technology: