Early menopause is associated with lack of response to Hepatitis C therapy

Early menopause is associated with lack of response to antiviral therapy in women with chronic hepatitis, finds March's publication of Gastroenterology.

Chronic hepatitis C and liver fibrosis progress more rapidly in men and menopausal women than in women of reproductive age.

Professor Erica Villa and colleagues from Italy investigated the associations among menopause, sustained virologic response, and liver damage in patients with chronic hepatitis C.

The research team performed a prospective study of 1000 consecutive, treatment-naïve patients 18 years of age and older with compensated liver disease from chronic hepatitis C.

Liver biopsy samples were analyzed before patients received standard antiviral therapy.
Baseline levels of liver inflammation were higher among postmenopausal women
Gastroenterology

The research team collected data from 442 women on the presence, type, and timing of menopause, associated hormone and metabolic features, serum levels of interleukin-6, and hepatic tumor necrosis factor-α.

Postmenopausal women achieved sustained virological response less frequently than women of reproductive age, but as frequently as men.

By multivariate regression analysis, an independent significant predictor for women to not achieve a sustained virological response was early menopause.

In addition, levels of γ-glutamyl transpeptidase, infection with hepatitis C virus genotype 1 or 4, and cholesterol levels were independent significant predictor for women to not achieve a sustained virological response.

Early menopause was the only independent factor that predicted lack of a sustained virological response among women with genotype 1 hepatitis C virus infection.

The team observed that baseline levels of liver inflammation, fibrosis, steatosis, serum interleukin-6, and hepatic tumor necrosis factor-α were significantly higher among postmenopausal women than women of reproductive age.

Professor Villa and colleagues conclude, "Among women with chronic hepatitis C, early menopause was associated with a low likelihood of sustained virological response, probably because of inflammatory factors that change at menopause."

Gastroenterol 2011: 140(3): 818-82911 March 2011