TY - JOUR
T1 - Early menopause is associated with lack of response to antiviral therapy in women with chronic hepatitis C
AU - Villa, Erica
AU - Karampatou, Aimilia
AU - Camm, Calogero
AU - Di Leo, Alfredo
AU - Luongo, Monica
AU - Ferrari, Anna
AU - Petta, Salvatore
AU - Losi, Luisa
AU - Taliani, Gloria
AU - Trande, Paolo
AU - Lei, Barbara
AU - Graziosi, Amalia
AU - Bernabucci, Veronica
AU - Critelli, Rosina
AU - Pazienza, Paola
AU - Rendina, Maria
AU - Antonelli, Alessandro
AU - Francavilla, Antonio
PY - 2011/3
Y1 - 2011/3
N2 - Background & Aims: Chronic hepatitis C (CHC) and liver fibrosis progress more rapidly in men and menopausal women than in women of reproductive age. We investigated the associations among menopause, sustained virologic response (SVR), and liver damage in patients with CHC. Methods: We performed a prospective study of 1000 consecutive, treatment-nave patients 18 years of age and older with compensated liver disease from CHC. Liver biopsy samples were analyzed (for fibrosis, inflammation, and steatosis) before patients received standard antiviral therapy. From women (n = 442), we collected data on the presence, type, and timing of menopause; associated hormone and metabolic features; serum levels of interleukin-6; and hepatic tumor necrosis factor (TNF)-α. Results: Postmenopausal women achieved SVRs less frequently than women of reproductive age (46.0% vs 67.5%; P <.0001) but as frequently as men (51.1%; P = .283). By multivariate regression analysis, independent significant predictors for women to not achieve an SVR were early menopause (odds ratio [OR], 8.055; 95% confidence interval [CI], 1.83425.350), levels of γ-glutamyl transpeptidase (OR, 2.165; 95% CI, 1.3643.436), infection with hepatitis C virus genotype 1 or 4 (OR, 3.861; 95% CI, 2.4336.134), and cholesterol levels (OR, 0.985; 95% CI, 0.9710.998). Early menopause was the only independent factor that predicted lack of an SVR among women with genotype 1 hepatitis C virus infection (OR, 3.933; 95% CI, 1.27412.142). Baseline levels of liver inflammation, fibrosis, steatosis, serum interleukin-6 (P = .04), and hepatic TNF-α (P = .007) were significantly higher among postmenopausal women than women of reproductive age. Conclusions: Among women with CHC, early menopause was associated with a low likelihood of SVR, probably because of inflammatory factors that change at menopause.
AB - Background & Aims: Chronic hepatitis C (CHC) and liver fibrosis progress more rapidly in men and menopausal women than in women of reproductive age. We investigated the associations among menopause, sustained virologic response (SVR), and liver damage in patients with CHC. Methods: We performed a prospective study of 1000 consecutive, treatment-nave patients 18 years of age and older with compensated liver disease from CHC. Liver biopsy samples were analyzed (for fibrosis, inflammation, and steatosis) before patients received standard antiviral therapy. From women (n = 442), we collected data on the presence, type, and timing of menopause; associated hormone and metabolic features; serum levels of interleukin-6; and hepatic tumor necrosis factor (TNF)-α. Results: Postmenopausal women achieved SVRs less frequently than women of reproductive age (46.0% vs 67.5%; P <.0001) but as frequently as men (51.1%; P = .283). By multivariate regression analysis, independent significant predictors for women to not achieve an SVR were early menopause (odds ratio [OR], 8.055; 95% confidence interval [CI], 1.83425.350), levels of γ-glutamyl transpeptidase (OR, 2.165; 95% CI, 1.3643.436), infection with hepatitis C virus genotype 1 or 4 (OR, 3.861; 95% CI, 2.4336.134), and cholesterol levels (OR, 0.985; 95% CI, 0.9710.998). Early menopause was the only independent factor that predicted lack of an SVR among women with genotype 1 hepatitis C virus infection (OR, 3.933; 95% CI, 1.27412.142). Baseline levels of liver inflammation, fibrosis, steatosis, serum interleukin-6 (P = .04), and hepatic TNF-α (P = .007) were significantly higher among postmenopausal women than women of reproductive age. Conclusions: Among women with CHC, early menopause was associated with a low likelihood of SVR, probably because of inflammatory factors that change at menopause.
KW - Antiviral Therapy
KW - HCV Therapy
KW - Menopause
KW - Prognostic Factors
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U2 - 10.1053/j.gastro.2010.12.027
DO - 10.1053/j.gastro.2010.12.027
M3 - Article
C2 - 21167831
AN - SCOPUS:79952308232
VL - 140
SP - 818
EP - 829
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 3
ER -