{"title":"病毒根除可降低接受过直接作用抗病毒疗法的慢性丙型肝炎病毒感染患者的全因死亡率。","authors":"Toshifumi Tada, Masayuki Kurosaki, Hidenori Toyoda, Nobuharu Tamaki, Yutaka Yasui, Shinichiro Nakamura, Nami Mori, Keiji Tsuji, Hironori Ochi, Takehiro Akahane, Haruhiko Kobashi, Hideki Fujii, Hiroyuki Marusawa, Masahiko Kondo, Naohito Urawa, Hideo Yoshida, Yasushi Uchida, Atsuhiro Morita, Chitomi Hasebe, Akeri Mitsuda, Chikara Ogawa, Ryoichi Narita, Yoshihito Kubotsu, Tomomichi Matsushita, Masaya Shigeno, Eisuke Okamoto, Kazuhiko Okada, Toyotaka Kasai, Toru Ishii, Michiko Nonogi, Satoshi Yasuda, Yuichi Koshiyama, Takashi Kumada, Namiki Izumi","doi":"10.1111/liv.16093","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aims</h3>\n \n <p>The impact of hepatitis C virus (HCV) eradication via direct-acting antiviral (DAA) therapy on overall mortality, particularly non-liver-related mortality, is understudied.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We recruited 4180 patients with chronic HCV infection who achieved sustained virological response (SVR) (HCV eradication) through DAA therapy (<i>n</i> = 2501, SVR group) or who did not receive antiviral therapy (<i>n</i> = 1679, non-SVR group); 1236 from each group were chosen using propensity score matching. Causes of death and all-cause mortality, including non-liver-related diseases, were investigated.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 4180 patients, 592 died during the follow-up period. In the SVR group, the mortality rates from liver-related and non-liver-related diseases were 16.5% and 83.5%, respectively. Compared to the non-SVR group, mortality rates from liver-related and non-liver-related diseases were 50.1% and 49.9%, respectively (<i>p</i> < .001). In non-cirrhotic patients, multivariable analysis revealed that SVR was an independent factor associated with both liver-related (hazard ratio [HR], .251; 95% confidence interval [CI], .092–.686) and non-liver-related (HR, .641; 95% CI, .415–.990) mortalities. In cirrhotic patients, multivariable analysis revealed that SVR remained an independent factor significantly associated with liver-related mortality (HR, .151; 95% CI, .081–.279). In propensity score-matched patients, the eradication of HCV (SVR group) decreased both liver-related (<i>p</i> < .001) and non-liver-related mortality (<i>p</i> = .008) rates compared to persistent HCV infection (non-SVR group).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The elimination of HCV via DAA therapy reduced not only liver-related mortality but also non-liver-related mortality in patients with chronic HCV.</p>\n </section>\n </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"44 11","pages":"3060-3071"},"PeriodicalIF":6.0000,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Viral eradication reduces all-cause mortality in patients with chronic hepatitis C virus infection who had received direct-acting antiviral therapy\",\"authors\":\"Toshifumi Tada, Masayuki Kurosaki, Hidenori Toyoda, Nobuharu Tamaki, Yutaka Yasui, Shinichiro Nakamura, Nami Mori, Keiji Tsuji, Hironori Ochi, Takehiro Akahane, Haruhiko Kobashi, Hideki Fujii, Hiroyuki Marusawa, Masahiko Kondo, Naohito Urawa, Hideo Yoshida, Yasushi Uchida, Atsuhiro Morita, Chitomi Hasebe, Akeri Mitsuda, Chikara Ogawa, Ryoichi Narita, Yoshihito Kubotsu, Tomomichi Matsushita, Masaya Shigeno, Eisuke Okamoto, Kazuhiko Okada, Toyotaka Kasai, Toru Ishii, Michiko Nonogi, Satoshi Yasuda, Yuichi Koshiyama, Takashi Kumada, Namiki Izumi\",\"doi\":\"10.1111/liv.16093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and Aims</h3>\\n \\n <p>The impact of hepatitis C virus (HCV) eradication via direct-acting antiviral (DAA) therapy on overall mortality, particularly non-liver-related mortality, is understudied.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We recruited 4180 patients with chronic HCV infection who achieved sustained virological response (SVR) (HCV eradication) through DAA therapy (<i>n</i> = 2501, SVR group) or who did not receive antiviral therapy (<i>n</i> = 1679, non-SVR group); 1236 from each group were chosen using propensity score matching. Causes of death and all-cause mortality, including non-liver-related diseases, were investigated.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of the 4180 patients, 592 died during the follow-up period. In the SVR group, the mortality rates from liver-related and non-liver-related diseases were 16.5% and 83.5%, respectively. Compared to the non-SVR group, mortality rates from liver-related and non-liver-related diseases were 50.1% and 49.9%, respectively (<i>p</i> < .001). In non-cirrhotic patients, multivariable analysis revealed that SVR was an independent factor associated with both liver-related (hazard ratio [HR], .251; 95% confidence interval [CI], .092–.686) and non-liver-related (HR, .641; 95% CI, .415–.990) mortalities. In cirrhotic patients, multivariable analysis revealed that SVR remained an independent factor significantly associated with liver-related mortality (HR, .151; 95% CI, .081–.279). In propensity score-matched patients, the eradication of HCV (SVR group) decreased both liver-related (<i>p</i> < .001) and non-liver-related mortality (<i>p</i> = .008) rates compared to persistent HCV infection (non-SVR group).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The elimination of HCV via DAA therapy reduced not only liver-related mortality but also non-liver-related mortality in patients with chronic HCV.</p>\\n </section>\\n </div>\",\"PeriodicalId\":18101,\"journal\":{\"name\":\"Liver International\",\"volume\":\"44 11\",\"pages\":\"3060-3071\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2024-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Liver International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/liv.16093\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Liver International","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/liv.16093","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Viral eradication reduces all-cause mortality in patients with chronic hepatitis C virus infection who had received direct-acting antiviral therapy
Background and Aims
The impact of hepatitis C virus (HCV) eradication via direct-acting antiviral (DAA) therapy on overall mortality, particularly non-liver-related mortality, is understudied.
Methods
We recruited 4180 patients with chronic HCV infection who achieved sustained virological response (SVR) (HCV eradication) through DAA therapy (n = 2501, SVR group) or who did not receive antiviral therapy (n = 1679, non-SVR group); 1236 from each group were chosen using propensity score matching. Causes of death and all-cause mortality, including non-liver-related diseases, were investigated.
Results
Of the 4180 patients, 592 died during the follow-up period. In the SVR group, the mortality rates from liver-related and non-liver-related diseases were 16.5% and 83.5%, respectively. Compared to the non-SVR group, mortality rates from liver-related and non-liver-related diseases were 50.1% and 49.9%, respectively (p < .001). In non-cirrhotic patients, multivariable analysis revealed that SVR was an independent factor associated with both liver-related (hazard ratio [HR], .251; 95% confidence interval [CI], .092–.686) and non-liver-related (HR, .641; 95% CI, .415–.990) mortalities. In cirrhotic patients, multivariable analysis revealed that SVR remained an independent factor significantly associated with liver-related mortality (HR, .151; 95% CI, .081–.279). In propensity score-matched patients, the eradication of HCV (SVR group) decreased both liver-related (p < .001) and non-liver-related mortality (p = .008) rates compared to persistent HCV infection (non-SVR group).
Conclusions
The elimination of HCV via DAA therapy reduced not only liver-related mortality but also non-liver-related mortality in patients with chronic HCV.
期刊介绍：
Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.
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