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Órgano Oficial de la Asociación Mexicana de Hepatología

2012, Number 5

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Ann Hepatol 2012; 11 (5)

Natural history of hepatitis C virus infection in a cohort of asymptomatic post-transfused subjects

Reggiardo MV, Fay F, Tanno M, García-Camacho G, Bottaso O, Ferretti S, Godoy A, Guerrita C, Paez M, Tanno F, Ruffinengo O, Benetti S, García BSE, Rossi MC, Vorobioff J, Bessone F, Tanno H

Language: English
References: 45
Page: 658-666
PDF size: 113.05 Kb.


ABSTRACT

Background & aims. Studies about the natural history of hepatitis C virus (HCV) infection report variable progression to cirrhosis depending on study design. Retrospective cross-sectional liver clinic studies overestimate the rate of fibrosis progression due to inclusion of patients with more severe disease leaving mild and asymptomatic patients underrepresented. We evaluated fibrosis progression in a group of “healthy” asymptomatic subjects, attending to a voluntary campaign for the detection of HCV infection. Material and methods. A detection campaign was launched on subjects transfused before 1993. Of 1699 volunteers, 61(3.6%) had HCV infection. A liver biopsy was performed in 40 (65%). Assessed risk factors for liver fibrosis were: sex, body mass index, alcohol consumption (› 20 g/d♀- ›40g/d ), genotype, HLA-DRB1 alleles, present age, age at infection and duration of infection. Results. 25 (62.5%) were women with a median age of 52.5 years. The median duration of infection was 21.5 years with a median age at infection of 27 years. As regards fibrosis, 25 (62.5%) had a Low Stage (F0-F1), 8 patients, 20%, had severe fibrosis, one patient (2.5%) had cirrhosis. Alcohol consumption was the only risk factor associated with fibrosis progression. Conclusions. The low progression to cirrhosis may be explained by the clinical characteristics of our population: asymptomatic middle-aged “healthy” subjects infected at young age. The progression to severe fibrosis was noticeable; hence a longer follow-up might demonstrate changes in this outcome. Significant alcohol consumption clearly worsens the natural history of HCV infection; this is no so evident for occasional or mild alcohol consumers.


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