Evidence map›Paper›PMID 27493457›Full record

ArticleJournal of clinical and experimental hepatology2016

Limited Fibrosis Progression but Significant Mortality in Patients Ineligible for Interferon-Based Hepatitis C Therapy.

Manhal Izzy, Ghalib Jibara, Aws Aljanabi, Mustafa Alani, Emily Giannattasio, Hina Zaidi, Zaid Said, Paul Gaglio, Allan Wolkoff, John F Reinus

Abstract read
In one paragraph

Article in Journal of clinical and experimental hepatology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Manhal IzzyDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
Ghalib JibaraDepartment of Urology, The Brookdale University Hospital and Medical Center, Brooklyn, NY, United States.
Aws AljanabiDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
Mustafa AlaniDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
Emily GiannattasioDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
Hina ZaidiDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
Zaid SaidDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
Paul GaglioDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
Allan WolkoffDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.
John F ReinusDepartment of Medicine, Division of Gastroenterology and Liver Diseases, Montefiore Medical Center, The Albert Einstein College of Medicine, Bronx, NY, United States.

Funding

Special Animal CoreP30DK041296 · NIDDK · YESHIVA UNIVERSITY · PI ROY-CHOWDHURY, JAYANTA · 1989 to 2018
$22.9M
Core-010UL1TR001073 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI KELLER, MARLA J, SHAMOON, HARRY · 2013 to 2017
$21.3M
NCATS NIH HHS UL1 TR001073NIDDK NIH HHS P30 DK041296
6 · The paper itself

Abstract

backgroundIndividuals ineligible for interferon-based hepatitis C therapy may have a worse prognosis than patients who have failed or not received treatment.

aimsTo provide information about the limitations of medical treatment of hepatitis C in real-world patients.

methodsWe studied 969 treatment-ineligible patients and 403 treated patients enrolled between 1/1/01 and 6/30/06; data were collected until 3/31/13. Treatment barriers were grouped into five categories and classified as health-related or health-unrelated. Fibrosis stage was assessed initially and at the end of follow-up. Mortality was determined by search of the Social Security database. Death certificates of treatment-ineligible patients were reviewed.

resultsInitially, 288 individuals had advanced fibrosis and compensated disease; 87 untreated patients developed advanced fibrosis during follow-up. Health-related treatment barriers were more commonly associated with fibrosis progression and worse survival. During follow-up, 247 untreated patients died: 47% of liver-related and 53% of liver-unrelated causes. Patients with significant comorbid illness had the worst five- (70%) and ten-year (50.5%) survival. Despite high mortality (47%) in persons with decompensated liver disease, no treatment barrier was associated with a greater incidence of liver-related death. Only significant comorbid medical illness was an independent predictor of disease progression; however, it was not associated with a greater incidence of liver-related death. Furthermore, treated patients had better 10-year survival than untreated patients on Kaplan-Meier analysis (80.3% vs. 74.5%, P = 0.005).

conclusionMany patients with hepatitis C will die of non-liver-related causes and may not be helped by anti-viral treatment.

Indexed as

AA, African-AmericanAPRI, aspartate-aminotransferase-to-platelet ratio indexDTB, dominant treatment barrierHCC, hepatocellular carcinomaHCV, hepatitis C virushepatitis Cliver fibrosismortalityprogressionSVR, sustained virologic responsetreatment barrier

Identifiers

PMID27493457
PMCPMC4963315

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.