Diabetes mellitus prevents an improvement in the serum albumin level during interferon-free sofosbuvir-based therapy for chronic hepatitis C patients: A multi-institutional joint study

Akira Kawano, Hirohisa Shigematsu, Koichiro Miki, Yasunori Ichiki, Chie Morita, Kimihiko Yanagita, Kazuhiro Takahashi, Kazufumi Dohmen, Hideyuki Nomura, Hiromi Ishibashi, Shinji Shimoda

Research output: Contribution to journalArticle

Abstract

Objective Interferon-free regimens of direct-acting antiviral agents have improved the treatment response for chronic hepatitis C virus (HCV) infection, and improvement in the serum albumin level during interferon-free therapy has been reported. The aim of this study was to identify the factors that influence the improvement in the serum albumin level in patients receiving interferon-free antiviral therapy. Methods This retrospective, multicenter study consisted of 471 Japanese patients with chronic hepatitis and compensated liver cirrhosis infected with HCV who completed 12-week interferon-free sofosbuvir (SOF)-based therapy [SOF plus ledipasvir for genotype 1 (n=276) and SOF with ribavirin for genotype 2 (n=195)]. We evaluated the changes in the serum albumin level from baseline to the end of treatment (ΔAlb). Results When compared with the normal-albumin group (baseline serum albumin >35 g/L, n=406), the low-albumin group (baseline serum albumin ≤35 g/L, n=65) showed a significant increase in the mean ΔAlb (5.5 g/L vs. 1.0 g/L, p<0.001). In the low-albumin group, a multivariate logistic regression analysis extracted diabetes mellitus as a negative predictive factor of median ΔAlb >5.0 g/L (odds ratio: 0.19, 95% confidence interval: 0.048-0.79, p=0.020). In the low-albumin group, the mean ΔAlb was significantly lower in the diabetic patients (n=14) than in the non-diabetic patients (n=51) (3.9 g/L and 5.7 g/L, p=0.049). Conclusion Interferon-free SOF-based therapy significantly improved the serum albumin in the low-albumin group patients with chronic HCV infection. However, the improvement in the serum albumin level was significantly lower in the diabetic patients than in the non-diabetic patients.

Original languageEnglish
Pages (from-to)1533-1542
Number of pages10
JournalInternal Medicine
Volume57
Issue number11
DOIs
Publication statusPublished - Jan 1 2018

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All Science Journal Classification (ASJC) codes

  • Internal Medicine

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