Original article—liver, pancreas, and biliary tractA Sustained Virologic Response Reduces Risk of All-Cause Mortality in Patients With Hepatitis C
Section snippets
Methods
We used data automatically extracted from the VA's electronic medical record into the Clinical Case Registry to identify veterans with HCV receiving care at any VA medical facility.16 A patient was included in the primary investigation if the following criteria were met: (1) had HCV genotype (GT) 1, 2, or 3; (2) started pegylated interferon (PEG-IFN)/ribavirin between January 20, 2001, and June 30, 2007; (3) stopped PEG-IFN/ribavirin treatment by June 30, 2008; and (4) had a HCV RNA test result
Results
We identified 22,942 patients who started and stopped treatment with PEG-IFN/ribavirin by the date criteria. Patients were excluded from the primary cohort for human immunodeficiency virus co-infection (649), hepatocellular carcinoma before treatment (64), an undetectable posttreatment HCV RNA but no test 12 weeks or more after the treatment end date (380), and no posttreatment HCV RNA test (4985). Sixty-five percent of the patients with no posttreatment HCV RNA test had a treatment duration of
Discussion
In this large US cohort of patients with HCV treated with PEG-IFN/ribavirin in routine medical practice, achieving SVR was associated with a significantly reduced risk of all-cause mortality for patients with GT1, GT2, and GT3, after adjusting for numerous baseline patient characteristics and comorbidities. Previous research has focused on liver-related mortality and thus any potential benefit of SVR on all-cause mortality, particularly in populations with substantial competing risk, has not
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Conflicts of interest The authors disclose no conflicts.
Funding All authors are supported by the US Department of Veterans Affairs, Veterans Health Administration, Office of Public Health and Environmental Hazards.