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Extrahepatic Malignancy Among Patients With Chronic Hepatitis C After Antiviral Therapy: A Real-World Nationwide Study on Taiwanese Chronic Hepatitis C Cohort (T-COACH).
Huang, Chung-Feng; Lai, Hsueh-Chou; Chen, Chi-Yi; Tseng, Kuo-Chih; Kuo, Hsing-Tao; Hung, Chao-Hung; Wang, Jing-Houng; Chen, Jyh-Jou; Lee, Pei-Lun; Chien, Rong-Nan; Yang, Chi-Chieh; Lo, Gin-Ho; Tai, Chi-Ming; Lin, Chih-Wen; Kao, Jia-Horng; Liu, Chun-Jen; Liu, Chen-Hua; Yan, Sheng-Lei; Bair, Ming-Jong; Lin, Chun-Yen; Su, Wei-Wen; Chu, Cheng-Hsin; Chen, Chih-Jen; Tung, Shui-Yi; Lo, Ching-Chu; Cheng, Pin-Nan; Chiu, Yen-Cheng; Wang, Chia-Chi; Cheng, Jin-Shiung; Tsai, Wei-Lun; Lin, Han-Chieh; Huang, Yi-Hsiang; Yeh, Ming-Lun; Huang, Jee-Fu; Dai, Chia-Yen; Chuang, Wan-Long; Tsai, Pei-Chien; Peng, Cheng-Yuan; Yu, Ming-Lung.
Afiliación
  • Huang CF; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Lai HC; Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan.
  • Chen CY; Department of Internal Medicine, Chiayi Christian Hospital, Chiayi, Taiwan.
  • Tseng KC; Department of Gastroenterology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.
  • Kuo HT; Division of Hepato-gastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
  • Hung CH; Division of Hepatogastroenterology, Department of Internal Medicine, ChiaYi Chang Gung Memorial Hospital, Chiayi, Taiwan.
  • Wang JH; Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
  • Chen JJ; Division of Gastroenterology and Hepatology, Chi-Mei Medical Center, Liouying, Tainan.
  • Lee PL; Division of Gastroenterology and Hepatology, Chi-Mei Medical Center, Liouying, Tainan.
  • Chien RN; Division of Hepatology, Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Yang CC; Division of Gastroenterology, Department of Internal Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.
  • Lo GH; Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
  • Tai CM; Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
  • Lin CW; Division of Gastroenterology and Hepatology, Department of Medicine, E-Da Hospital, School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
  • Kao JH; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
  • Liu CJ; Division of Gastroenterology and Hepatology, the National Taiwan University Hospital, Taipei, Taiwan.
  • Liu CH; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
  • Yan SL; Division of Gastroenterology and Hepatology, the National Taiwan University Hospital, Taipei, Taiwan.
  • Bair MJ; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
  • Lin CY; Division of Gastroenterology and Hepatology, the National Taiwan University Hospital, Taipei, Taiwan.
  • Su WW; Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show-Chwan Memorial Hospital, Changhua City, Taiwan.
  • Chu CH; Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung City, Taiwan.
  • Chen CJ; Division of Hepatology, Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Tung SY; Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
  • Lo CC; Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
  • Cheng PN; Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan.
  • Chiu YC; Division of Hepatogastroenterology, Department of Internal Medicine, ChiaYi Chang Gung Memorial Hospital, Chiayi, Taiwan.
  • Wang CC; Department of Internal Medicine, St. Martin De Porres Hospital, Daya, Chiayi, Taiwan.
  • Cheng JS; Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • Tsai WL; Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • Lin HC; Division of Gastroenterology, Department of Internal Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, New Taipei City, Taiwan.
  • Huang YH; Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Yeh ML; Division of Gastroenterology and Hepatology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Huang JF; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Dai CY; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chuang WL; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Tsai PC; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Peng CY; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Yu ML; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Am J Gastroenterol ; 115(8): 1226-1235, 2020 08.
Article en En | MEDLINE | ID: mdl-32221162
INTRODUCTION: Chronic hepatitis C virus (HCV) infection is associated with nonhepatocellular carcinoma malignancies. We aimed to evaluate whether achieving a sustained virological response (SVR, defined as HCV RNA seronegativity throughout posttreatment 24-week follow-up) could reduce the risk of non-hepatocellular carcinoma malignancy in a real-world nationwide Taiwanese Chronic Hepatitis C Cohort (T-COACH). METHODS: A total of 10,714 patients with chronic hepatitis C who had received interferon-based therapy (8,186 SVR and 2,528 non-SVR) enrolled in T-COACH and were linked to the National Cancer Registry database for the development of 12 extrahepatic malignancies, including those with potential associations with HCV and with the top-ranking incidence in Taiwan, over a median follow-up period was 3.79 years (range, 0-16.44 years). RESULTS: During the 44,354 person-years of follow-up, 324 (3.02%) patients developed extrahepatic malignancies, without a difference between patients with and without SVR (annual incidence: 0.69% vs 0.87%, respectively). Compared with patients with SVR, patients without SVR had a significantly higher risk of gastric cancer (0.10% vs 0.03% per person-year, P = 0.004) and non-Hodgkin lymphoma (NHL) (0.08% vs 0.03% per person-year, respectively, P = 0.03). When considering death as a competing risk, non-SVR was independently associated with gastric cancer (hazard ratio [HR]/95% confidence intervals [CIs]: 3.29/1.37-7.93, P = 0.008). When patients were stratified by age, the effect of SVR in reducing gastric cancer (HR/CI: 0.30/0.11-0.83) and NHL (HR/CI: 0.28/0.09-0.85) was noted only in patients aged <65 years but not those aged >65 years. DISCUSSION: HCV eradication reduced the risk of gastric cancer and NHL, in particular among younger patients, indicating that patients with chronic hepatitis C should be treated as early as possible.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Antivirales / Neoplasias Gástricas / Linfoma no Hodgkin / Hepatitis C Crónica / Respuesta Virológica Sostenida Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Am J Gastroenterol Año: 2020 Tipo del documento: Article País de afiliación: Taiwán
Texto completo
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Antivirales / Neoplasias Gástricas / Linfoma no Hodgkin / Hepatitis C Crónica / Respuesta Virológica Sostenida Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Am J Gastroenterol Año: 2020 Tipo del documento: Article País de afiliación: Taiwán