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 21 February 2018

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News

Clinical course of hepatitis C virus during the first decade of infection

Research published in the latest issue of the British Medical Journal has investigated the clinical course of hepatitis C virus (HCV) in the first decade of infection.

News image

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A team from London, England, conducted the research among a group of patients who acquired their infections on a known date.

Some 924 transfusion recipients, infected with HCV, traced during the HCV lookback program, were included in the cohort study.

An additional 475 transfusion recipients, who tested negative for antibodies to HCV (controls), were enrolled.

Clinical evidence of liver disease and survival after 10 years of infection were both determined.

All cause mortality was not found to be significantly different between patients and controls (Cox's hazards ratio, 1.4).

Patients were more likely to be certified with a death related to liver disease than were controls (12.8). However, although the risk of death directly from liver disease was higher in patients than controls, this difference was not significant (5.8).

Of the patients who died directly from liver disease, 40% were known to have consumed excess alcohol.

Risk of dying from liver disease not statistically significant between HCV-infected patients and controls.
British Medical Journal

Clinical follow-up of 826 patients showed that liver function was abnormal in 307 (37%), and 115 (14%) reported physical signs or symptoms of liver disease.

Factors associated with developing liver disease were testing positive for HCV ribonucleic acid (odds ratio 6.4), having acquired infection when older (at age ≥ 40 years; 1.8), and years since transfusion (odds ratio 1.1 per year).

The researchers found that, for patients with severe disease, sex was also significant (odds ratio for women, 0.4).

Of the 362 patients who had undergone liver biopsy, it was discovered that 328 (91%) had abnormal histological results, and 35 (10%) of these were cirrhotic.

Helen E. Harris, of the Public Health Laboratory Service Communicable Disease Surveillance Centre, London, said on behalf of her group, "Hepatitis C virus infection did not have a great impact on all cause mortality in the first decade of infection."

"Infected patients were at increased risk of dying directly from liver disease, particularly if they consumed excess alcohol, but this difference was not statistically significant," she concluded.

BMJ 2002; 324: 450
25 February 2002

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