Interferon-Based Therapy Decreases Risks of Hepatocellular Carcinoma and Complications of Cirrhosis in Chronic Hepatitis C Patients

<div><p>Background</p><p>Interferon-based therapy (IBT) has been the standard of care for hepatitis C virus (HCV) infection. However, conflicting results exist regarding the effects of IBT on risk of developing hepatocellular carcinoma (HCC) and cirrhosis-associated complications, and most included highly selected patients.</p><p>Methods</p><p>This 8-year cohort study was based on the Longitudinal Health Insurance Database 2000 (LHID 2000) consisting of 1,000,000 beneficiaries randomly selected from all Taiwan National Health Insurance enrollees in 2000 (>23.7 million). Patients with newly detected HCV infections (n = 11,264) were classified based on treatment and clinical outcomes. IBTs were defined as regimens that included interferon- alfa, pegylated interferon- alfa -2a, or pegylated interferon- alfa -2b for at least 3 months. The Cox proportional hazards models were used to estimate the hazard ratio (HR) and associated confidence interval (CI) of HCC and cirrhosis-associated complications for IBT.</p><p>Results</p><p>The 8-year incidence rate for HCC was 3.9% among patients who received IBT and 5.6% among those who did not. The HCC-free survival rate was significantly higher among patients receiving IBT during the 8-year period than their counterpart (adjusted HR, 0.50; 95% CI, 0.31–0.81; P = .004). Similarly, the event-free survival rates for esophageal variceal bleeding (adjusted HR, 0.45; 95% CI, 0.22–0.91; P = .026), hepatic encephalopathy (adjusted HR, 0.38; 95% CI, 0.21–0.69; P = .001), ascites (adjusted HR, 0.28; 95% CI, 0.14–0.57; P<.001), and cirrhosis (adjusted HR, 0.63; 95% CI, 0.44–0.91; P = .013) were significantly higher among patients who received IBT than those who did not, after adjustment for associated factors.</p><p>Conclusion</p><p>Treatment with interferon may reduce the 8-year risk of HCC and cirrhosis-associated complications in patients with chronic HCV infection.</p></div

Hepatocellular carcinoma-free survival rate by different interferon-based treatment conditions as estimated by the Cox proportional hazards model in patients with hepatitis C viral infection.

<p><6 months IBT <i>vs.</i> no treatment, p = 0.264; ≧6 months IBT <i>vs.</i> no treatment, p = 0.006. IBT = interferon-based treatment. The y-axis is modified, so that it only displays the survival estimates between 0.94 and 1.00.</p

The effect of duration of interferon-based therapy on risks of hepatocellular carcinoma and cirrhosis complications.

a<p>P<0.05. Tested by Cox regression. Sample sizes for each of the clinical outcomes indicate the number of subjects WITHOUT the diagnosis of that clinical outcome before and within 6 months after the HCV index date. ^* Adjusted for cirrhosis after the index day. ^† Adjusted for age, sex, hepatitis B, CRF, cirrhosis after the index day, and the number of ultrasonography examinations after the index day. ^‡ Adjusted for age, sex, diabetes mellitus, IHD, cerebrovascular disease, COPD, hepatitis B, CRF, cirrhosis after the index day, and the number of ultrasonography examinations after the index day. ^§Adjusted for age, sex, hepatitis B, and the number of ultrasonography examinations after the index day. ^£Adjusted for age, sex, diabetes mellitus, IHD, cerebrovascular disease, COPD, hepatitis B, CRF, and the number of ultrasonography examinations after the index day. <b>Abbreviations:</b> IBT, interferon-based therapy; HCC, hepatocellular carcinoma; IHD, ischemic heart diseases; COPD, chronic obstructive pulmonary diseases; CRF, chronic renal failure.</p

The effect of interferon-based therapy on risks of hepatocellular carcinoma and cirrhosis complications.

a<p>P<0.05. Tested by Cox regression. Sample sizes for each of the clinical outcomes indicate the number of subjects WITHOUT the diagnosis of that clinical outcome before and within 6 months after the HCV index date. ^* Adjusted for cirrhosis after the index day. ^† Adjusted for age, sex, hepatitis B, CRF, cirrhosis after the index day, and the number of ultrasonography examinations after the index day. ^#Adjusted age, sex, IHD, hepatitis B, CRF, cirrhosis after the index day, and the number of ultrasonography examinations after the index day. ^‡ Adjusted for age, sex, diabetes mellitus, IHD, cerebrovascular disease, COPD, hepatitis B, CRF, cirrhosis after the index day, and the number of ultrasonography examinations after the index day. ^§Adjusted for age, sex, hepatitis B, CRF, and the number of ultrasonography examinations after the index day. ^£Adjusted for age, sex, diabetes mellitus, IHD, cerebrovascular disease, COPD, hepatitis B, CRF, and the number of ultrasonography examinations after the index day. Abbreviations: IBT, interferon-based therapy; HCC, hepatocellular carcinoma; IHD, ischemic heart diseases; COPD, chronic obstructive pulmonary diseases; CRF, chronic renal failure.</p

Baseline characteristics of Hepatitis C patients enrolled for analyses of clinical outcomes, including hepatocellular carcinoma and complications of cirrhosis, stratified according to the use of interferon.

a<p>P<0.05. Tested by the Mann-Whitney U test and the Chi-square test. Sample sizes for each of the clinical outcomes indicate the number of subjects WITHOUT the diagnosis of that clinical outcome before and within 6 months after the HCV index date. <b>Abbreviations:</b> IBT, interferon-based therapy; DM, diabetes mellitus; HIV, human immunodeficiency virus; IHD, ischemic heart diseases; CVD, Cerebrovascular disease; COPD, chronic obstructive pulmonary diseases; CRF, chronic renal failure.</p

sj-docx-1-nnr-10.1177_15459683231170539 – Supplemental material for Effects of Neurofeedback on Cognitive Function, Productive Activity, and Quality of Life in Patients With Traumatic Brain Injury: A Randomized Controlled Trial

Supplemental material, sj-docx-1-nnr-10.1177_15459683231170539 for Effects of Neurofeedback on Cognitive Function, Productive Activity, and Quality of Life in Patients With Traumatic Brain Injury: A Randomized Controlled Trial by Pin-Yuan Chen, I-Chang Su, Chun-Ying Shih, Yen-Chun Liu, Yu-Kai Su, Li Wei, Hui-Tzung Luh, Hui-Chuan Huang, Pei-Shan Tsai, Yen-Chun Fan and Hsiao-Yean Chiu in Neurorehabilitation and Neural Repair</p