The team evaluated the progression of liver fibrosis in untreated patients with hepatitis C virus (HCV) infection, and reported their results in the latest issue of Liver.
A total of 98 patients with HCV were included in the study.
Two liver biopsy specimens, obtained prior to antiviral therapy, were taken from each patient.
These were scored and evaluated using statistical methods appropriate for ordered categorical data.
Greater progression of fibrosis was seen with increasing time between the biopsies.
Likewise, the change in fibrosis score was significantly more pronounced in the 11 patients whose first biopsy was obtained within the first year after acquiring HCV.
A multivariate logistic regression analysis showed that interface hepatitis in both biopsies, the time interval between the biopsies, and age at first biopsy, were associated with change in the fibrosis score.
In addition, the authors found that older age at the time of infection was associated with development of cirrhosis.
Furthermore, moderate intake of alcohol was associated with fibrosis progression.
|Factors linked with fibrosis progression:|
- Interface hepatitis
- Older age at diagnosis
- Alcohol intake
An inflammatory response, in the form of moderate interface hepatitis in the first biopsy, was not necessarily associated with greater progression of fibrosis if the second biopsy showed mild interface hepatitis.
However, having moderate interface hepatitis later in the course of infection, as reflected by the second biopsy, may be detrimental.
Author L. Martin Lagging, of Göteborg University, Göteborg, Sweden, concluded on behalf of his colleagues, "If moderate interface hepatitis occurs early in the course of the disease, and is followed by less interface hepatitis later on, there is less fibrosis.
"However, if moderate interface hepatitis persists, there is more fibrosis eventually."