Abstract
Aim of this study was to evaluate long-term prognosis of HCV-positive liver cirrhotic patients who received interferon (IFN) therapy after partial splenic embolization (PSE) or splenectomy for thrombocytopenia in a cohort study.
The survival rate of PSE- or splenectomy-treated patients (PSE-splenectomy group) was higher than control-group from the beginning of observation period, and especially at three or four years' observation, PSE-splenectomy group achieved statistical significantly higher survival rate; the survival rate of PESsplenectomy group or control-group was 93% , 66% , respectively (p = 0.034) at three years' observation, and 93% , 61% , respectively (p = 0.016) at four years' observation. In addition, we compared survival rate of the patients with or without sustained virological response (SVR) after IFN therapy. Prognosis of the patients who achieved SVR was good in PSE-splenectomy group, but there was no statistical significant difference compared with control group. The factors contributing to survival during four years' observation period were albumin at baseline (p =< 0.001), existence of liver cancer (p = 0.008), and performance of PSEsplenectomy (p = 0.031).
These results indicate that PSE or splenectomy could not only expand indication of IFN treatment but also improve the prognosis of HCV-positive liver cirrhotic patients.
