当前位置：
X-MOL 学术
›
Gastroenterology
›
论文详情
Our official English website, www.x-mol.net, welcomes your
feedback! (Note: you will need to create a separate account there.)
Direct-Acting Antiviral Therapy for Hepatitis C Virus Infection Is Associated With Increased Survival in Patients With a History of Hepatocellular Carcinoma.
Gastroenterology ( IF 25.7 ) Pub Date : 2019-07-30 , DOI: 10.1053/j.gastro.2019.07.040 Amit G Singal 1 , Nicole E Rich 1 , Neil Mehta 2 , Andrea D Branch 3 , Anjana Pillai 4 , Maarouf Hoteit 5 , Michael Volk 6 , Mobolaji Odewole 1 , Steven Scaglione 7 , Jennifer Guy 8 , Adnan Said 9 , Jordan J Feld 10 , Binu V John 11 , Catherine Frenette 12 , Parvez Mantry 13 , Amol S Rangnekar 14 , Omobonike Oloruntoba 15 , Michael Leise 16 , Janice H Jou 17 , Kalyan Ram Bhamidimarri 18 , Laura Kulik 19 , George N Ioannou 20 , Annsa Huang 2 , Tram Tran 21 , Hrishikesh Samant 22 , Renumathy Dhanasekaran 23 , Andres Duarte-Rojo 24 , Reena Salgia 25 , Sheila Eswaran 26 , Prasun Jalal 27 , Avegail Flores 28 , Sanjaya K Satapathy 29 , Sofia Kagan 1 , Purva Gopal 30 , Robert Wong 31 , Neehar D Parikh 32 , Caitlin C Murphy 1
Gastroenterology ( IF 25.7 ) Pub Date : 2019-07-30 , DOI: 10.1053/j.gastro.2019.07.040 Amit G Singal 1 , Nicole E Rich 1 , Neil Mehta 2 , Andrea D Branch 3 , Anjana Pillai 4 , Maarouf Hoteit 5 , Michael Volk 6 , Mobolaji Odewole 1 , Steven Scaglione 7 , Jennifer Guy 8 , Adnan Said 9 , Jordan J Feld 10 , Binu V John 11 , Catherine Frenette 12 , Parvez Mantry 13 , Amol S Rangnekar 14 , Omobonike Oloruntoba 15 , Michael Leise 16 , Janice H Jou 17 , Kalyan Ram Bhamidimarri 18 , Laura Kulik 19 , George N Ioannou 20 , Annsa Huang 2 , Tram Tran 21 , Hrishikesh Samant 22 , Renumathy Dhanasekaran 23 , Andres Duarte-Rojo 24 , Reena Salgia 25 , Sheila Eswaran 26 , Prasun Jalal 27 , Avegail Flores 28 , Sanjaya K Satapathy 29 , Sofia Kagan 1 , Purva Gopal 30 , Robert Wong 31 , Neehar D Parikh 32 , Caitlin C Murphy 1
Affiliation
|
BACKGROUND & AIMS
There is controversy regarding the benefits of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection for patients with a history of hepatocellular carcinoma (HCC). We performed a multicenter cohort study to compare overall survival between patients with HCV infection treated with DAAs and patients who did not receive DAA treatment for their HCV infection after complete response to prior HCC therapy.
METHODS
We conducted a retrospective cohort study of patients with HCV-related HCC who achieved a complete response to resection, local ablation, transarterial chemo- or radioembolization, or radiation therapy, from January 2013 through December 2017 at 31 health care systems throughout the United States and Canada. We used Cox proportional hazards regression to determine the association between receipt of DAA therapy, modeled as a time-varying covariate, and all-cause mortality, accounting for informative censoring and confounding using inverse probability weighting.
RESULTS
Of 797 patients with HCV-related HCC, 383 (48.1%) received DAA therapy and 414 (51.9%) did not receive treatment for their HCV infection after complete response to prior HCC therapy. Among DAA-treated patients, 43 deaths occurred during 941 person-years of follow-up, compared with 103 deaths during 526.6 person-years of follow-up among patients who did not receive DAA therapy (crude rate ratio, 0.23; 95% confidence interval [CI], 0.16-0.33). In inverse probability-weighted analyses, DAA therapy was associated with a significant reduction in risk of death (hazard ratio, 0.54; 95% CI, 0.33-0.90). This association differed by sustained virologic response to DAA therapy; risk of death was reduced in patients with sustained virologic response to DAA therapy (hazard ratio, 0.29; 95% CI, 0.18-0.47), but not in patients without a sustained virologic response (hazard ratio, 1.13; 95% CI, 0.55-2.33).
CONCLUSIONS
In an analysis of nearly 800 patients with complete response to HCC treatment, DAA therapy was associated with a significant reduction in risk of death.
中文翻译：
丙型肝炎病毒感染的直接作用抗病毒治疗与具有肝细胞癌病史的患者的生存率增加相关。
背景与目的对于具有肝细胞癌（HCC）病史的患者，直接作用抗病毒（DAA）治疗丙型肝炎病毒（HCV）感染的益处存在争议。我们进行了一项多中心队列研究，以比较接受DAA治疗的HCV感染患者与未对先前HCC治疗完全应答后接受DAA治疗的HCV感染患者的总体生存率。方法我们进行了一项回顾性队列研究，研究对象为2013年1月至2017年12月在美国31个医疗体系中对切除，局部消融，经动脉化学或放射栓塞或放射治疗完全反应的HCV相关性HCC患者和加拿大。我们使用Cox比例风险回归来确定以时变协变量为模型的DAA治疗的接受与全因死亡率之间的关联，这说明了使用反向概率加权的信息审查和混淆。结果在797例与HCV相关的HCC患者中，有383例（48.1％）接受了DAA治疗，而414例（51.9％）在对先前的HCC治疗完全反应后没有接受HCV感染的治疗。在接受DAA治疗的患者中，有941例随访期间发生了43例死亡，而未接受DAA治疗的患者中有526.6例随访期间发生了103例死亡（原始比率为0.23；置信度为95％）区间[CI]，0.16-0.33）。在逆概率加权分析中，DAA治疗可显着降低死亡风险（危险比，0.54； 95％CI，0。33-0.90）。这种关联的不同之处在于对DAA治疗的持续病毒学应答；对DAA疗法具有持续病毒学应答的患者（危险比，0.29; 95％CI，0.18-0.47）降低了死亡风险，但没有持续病毒学应答的患者（危险比，1.13; 95％CI，0.55-）没有降低2.33）。结论在对近800例对HCC治疗完全缓解的患者进行的分析中，DAA治疗可显着降低死亡风险。
更新日期：2019-11-18
中文翻译：
丙型肝炎病毒感染的直接作用抗病毒治疗与具有肝细胞癌病史的患者的生存率增加相关。
背景与目的对于具有肝细胞癌（HCC）病史的患者，直接作用抗病毒（DAA）治疗丙型肝炎病毒（HCV）感染的益处存在争议。我们进行了一项多中心队列研究，以比较接受DAA治疗的HCV感染患者与未对先前HCC治疗完全应答后接受DAA治疗的HCV感染患者的总体生存率。方法我们进行了一项回顾性队列研究，研究对象为2013年1月至2017年12月在美国31个医疗体系中对切除，局部消融，经动脉化学或放射栓塞或放射治疗完全反应的HCV相关性HCC患者和加拿大。我们使用Cox比例风险回归来确定以时变协变量为模型的DAA治疗的接受与全因死亡率之间的关联，这说明了使用反向概率加权的信息审查和混淆。结果在797例与HCV相关的HCC患者中，有383例（48.1％）接受了DAA治疗，而414例（51.9％）在对先前的HCC治疗完全反应后没有接受HCV感染的治疗。在接受DAA治疗的患者中，有941例随访期间发生了43例死亡，而未接受DAA治疗的患者中有526.6例随访期间发生了103例死亡（原始比率为0.23；置信度为95％）区间[CI]，0.16-0.33）。在逆概率加权分析中，DAA治疗可显着降低死亡风险（危险比，0.54； 95％CI，0。33-0.90）。这种关联的不同之处在于对DAA治疗的持续病毒学应答；对DAA疗法具有持续病毒学应答的患者（危险比，0.29; 95％CI，0.18-0.47）降低了死亡风险，但没有持续病毒学应答的患者（危险比，1.13; 95％CI，0.55-）没有降低2.33）。结论在对近800例对HCC治疗完全缓解的患者进行的分析中，DAA治疗可显着降低死亡风险。
京公网安备 11010802027423号