It is necessary to follow large groups of patients for long periods to establish the rates, chronology, and hierarchy of complications of cirrhosis, and other potential causes of liver disease.
In this study, scientists followed a cohort of 214 patients with compensated cirrhosis due to hepatitis C virus (HCV) for 17 years.
Study subjects were HCV RNA-seropositive with Child-Pugh class A cirrhosis.
They had no previous clinical decompensation.
The team found that hepatocellular carcinoma (HCC) developed in 32%of patients during follow-up.
Ascites developed in 23%, jaundice in 17%, upper gastrointestinal bleeding in 6%, and encephalopathy in 1%.
|Annual mortality rate was 4% per year.|
They found that clinical status remained unchanged in 72%, progressed to Child-Pugh class B in 21% and class C in 7%.
The scientists determined that HCC was the cause of death in 44% of patients and also the first complication to develop in 27%.
Overall, the annual mortality rate was 4% per year.
Dr Angelo Sangiovanni's team concluded, "Hepatitis C-related cirrhosis is a slowly progressive disease that may be accelerated by other potential causes of liver disease".
"HCC was the first complication to develop and the dominant cause for increased mortality".