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

he 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 catego
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Contact: Dawn Peters
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Wiley-Blackwell
Source:Eurekalert

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