December 17, 2010

Progression of initially mild hepatic fibrosis in patients with chronic hepatitis C infection

J Viral Hepat. 2011 Jan;18(1):17-22. doi: 10.1111/j.1365-2893.2009.01262.x.

Williams MJ, Lang-Lenton M; on behalf of the Trent HCV Study Group.

Nottingham Digestive Diseases Centre, Nottingham University Hospital, Nottingham, UK.


Summary.  A significant number of patients with chronic hepatitis C infection have minimal fibrosis at presentation. Although the short-term outlook for such patients is good, there are limited data available on long-term progression. We assessed the risk of fibrosis progression in 282 patients with chronic hepatitis C with Ishak stage 0 or 1 fibrosis on initial liver biopsy. Progression of fibrosis stage occurred in 118 patients (42%) over a median interval of 52.5 months. Thirteen (5%) progressed to severe (Ishak stage 4 or more) fibrosis. Progression was significantly associated with both age at initial biopsy [odds ratio (OR) for progression of 1.31 per 10 year increase in age] and median alanine transaminase (ALT) levels during follow-up (OR of 1.06 per 10 IU/L increase). There was no significant association with gender, histological inflammatory grade, hepatic steatosis or body mass index. We conclude that hepatitis C with initially mild fibrosis does progress in a substantial proportion of patients and should not be viewed as a benign disease. Early antiviral therapy should be considered in older patients and those with high ALT levels.

© 2010 Blackwell Publishing Ltd.

PMID: 20088889 [PubMed - as supplied by publisher]


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