The prevalence of significant liver disease in people with asymptomatic hepatitis C virus (HCV) infection is unclear.
In this study, researchers from Padova, Italy, determined the prevalence and severity of HCV infection in asymptomatic individuals.
The research team performed a population-based cross-sectional study.
|Prevalence of HCV infection increased with age.|
|Annals of Internal Medicine|
They assessed 4820 subjects who were undergoing screening for cardiovascular risk factors.
The team performed initial screening for anti-HCV by enzyme-linked immunosorbent assay.
This was followed by HCV RNA testing by polymerase chain reaction, and monitoring of alanine aminotransferase levels in viremic persons.
In addition, 92% of viremic subjects had liver biopsies to assess their METAVIR scores.
The research team found that 116 subjects were positive for anti-HCV, 85 of these were also viremic.
ALT levels were normal in 46% of viremic patients, but elevated in 54%.
The team detected significant hepatic histologic abnormalities in 19% of patients with persistently normal ALT levels, and in 61% with elevated ALT levels.
Furthermore, they found that the prevalence of HCV infection, and number of subjects with chronic liver fibrosis increased with age.
Dr Alfredo Alberti’s team concluded, “Hepatitis C is histologically active and progressive in up to 40% of asymptomatic persons with HCV infection”.
“The severity of liver disease correlates with abnormal ALT levels and increases with age”.