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J. Hepatol. (2001) 34(5): 730-9
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Date Posted: Mon, July 30 2001, 8:06:13 PDT
Rates and risk factors of liver fibrosis progression in patients with
chronic hepatitis C
Poynard T., Ratziu V., Charlotte F., Goodman Z.,
McHutchison J., Albrecht J. Rates and risk factors of liver fibrosis progression J. Hepatol. (2001) 34(5): 730-9
Background aims
In hepatitis C there is controversy over the linearity of the rate of
progression and the significance of gender, mode of infection and viral
factors.
Methods
2313 untreated patients with a reliable estimated duration of infection and
liver fibrosis were included. Fibrosis progression was calculated using the
Kaplan-Meier method and the rate of fibrosis progression using the hazard
function. Seven risk factors were assessed: age at biopsy, gender, alcohol
consumption, mode of infection, activity grade, hepatitis C virus genotype
and RNA level.
Results
The percentage of patients without cirrhosis was 91% after 20 years of
infection (95% CI:90-92%) and 56% after 40 years (95% CI:48-64%). Three
independent factors were associated (P < 0.001) with a faster progression
rate:
age at infection, alcohol consumption of 50 g or more per day, and male
gender. The mode of infection, histologic activity, genotype and viral load
were not independently associated with fibrosis. Fibrosis progression was
mainly dependent on age and the duration of infection and can be divided
into four successive periods with very slow, slow, intermediate and rapid
progression rates.
Conclusion
In patients infected with hepatitis C, the majority of fibrosis progression
occurred in those aged 50years or older.
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