Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital, Tokyo, Japan.
J Med Virol. 2010 Mar;82(3):390-5. doi: 10.1002/jmv.21691.
Osteoporosis is often present in postmenopausal women. The aim of this retrospective cohort study was to assess the cumulative incidence and predictive factors for bone fracture after cessation of interferon (IFN) in postmenopausal women with osteoporosis and chronic liver disease caused by hepatitis C virus (HCV). A total of 420 postmenopausal women treated with IFN monotherapy were enrolled. The mean observation period was 7.2 years. The primary goal was the development of bone fracture. Evaluation was carried out by using the Kaplan-Meier method and the Cox proportional hazards analysis. Thirty-one out of 420 patients sustained bone fracture. The cumulative development rate of bone fracture was 3.6% at 5th year, 9.2% at 10th year, and 17.4% at 15th year. Multivariate Cox proportional hazards analysis showed that bone fracture after cessation of IFN therapy occurred when histological staging of the liver was advanced (hazard ratio (HR): 2.54; 95% confidence interval (CI) = 1.21-5.31; P = 0.013), serum albumin level was < 3.5g/dl (HR: 2.25; 95% CI = 1.10-4.59; P = 0.026), and virus clearance was not achieved (HR: 3.65; 95% CI = 1.11-12.05; P = 0.033). The results indicate that virus clearance causes a reduction of two-thirds in the risk of bone fracture after cessation of IFN therapy in postmenopausal women with osteoporosis and chronic liver disease caused by HCV. J. Med. Virol. 82:390-395, 2010. (c) 2010 Wiley-Liss, Inc.
骨质疏松症在绝经后妇女中很常见。本回顾性队列研究的目的是评估绝经后骨质疏松症和丙型肝炎病毒（HCV）引起的慢性肝病女性停止干扰素（IFN）治疗后骨折的累积发生率和预测因素。共纳入 420 例接受 IFN 单药治疗的绝经后妇女。平均观察期为 7.2 年。主要目标是发生骨折。通过 Kaplan-Meier 方法和 Cox 比例风险分析进行评估。420 例患者中有 31 例发生骨折。骨折的累积发展率为第 5 年 3.6%，第 10 年 9.2%，第 15 年 17.4%。多变量 Cox 比例风险分析显示，当肝组织学分期进展时（风险比（HR）：2.54；95%置信区间（CI）= 1.21-5.31；P = 0.013），血清白蛋白水平<3.5g/dl（HR：2.25；95%CI = 1.10-4.59；P = 0.026），病毒清除未达到（HR：3.65；95%CI = 1.11-12.05；P = 0.033）时，IFN 治疗停止后发生骨折。结果表明，病毒清除可使 HCV 引起的绝经后骨质疏松症和慢性肝病女性停止 IFN 治疗后骨折风险降低三分之二。J. Med. Virol. 82:390-395, 2010. （c）2010 Wiley-Liss, Inc.
