Peginterferon in Hepatitis C Linked to Higher Mortality

Long-term treatment associated with increased mortality from non-liver-related causes

FRIDAY, May 13 (HealthDay News) -- Long-term peginterferon treatment in patients with advanced chronic hepatitis C is associated with higher overall mortality mainly due to non-liver-related causes, according to a study published in the April issue of Hepatology.

Adrian M. Di Bisceglie, M.D., from the Saint Louis University School of Medicine, and colleagues determined the frequency and causes of death in 1,050 patients with advanced chronic hepatitis C who were part of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis trial. The participants, who had failed to respond to previous antiviral therapy, were randomized to receive either long-term peginterferon or no therapy (controls). The patients were followed up for an average of 5.7 years, during which time the investigators assessed liver transplantation rates, and categorized deaths as liver or nonliver related, and as related or not related to peginterferon complications.

The investigators identified 74 patients who underwent liver transplantation and 122 deaths (12 percent), of which 62 percent were liver-related and 38 percent non-liver related. Patients in the peginterferon group had higher cumulative mortality rate at seven years than the control group (20 versus 15 percent; P = 0.049). This difference was higher in patients with fibrosis than in patients with cirrhosis (14 versus 7 percent). The differences were similar when transplant patients were included. Mortality after three years of treatment was largely non-liver related with no identifiable cause, and one death was suspected to be a direct peginterferon complication. Treatment and control groups had similar liver-related mortality.

"An increase in mortality occurred in patients in the long-term peginterferon treatment group, but this increase in mortality was attributed to non-liver-related deaths and occurred largely among patients with pre-cirrhotic advanced fibrosis at baseline," the authors write.

Several of the study authors disclosed financial relationships with the pharmaceutical industry, including Hoffmann-La Roche Inc. (now Genentech), which partially funded the study.

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