In
an attempt to better understand the risk factors for fibrosis progression in groups
with a high prevalence of HCV infection, researchers compared demographic, clinical,
and independent variables influencing fibrosis progression in 459 U.S. veterans
and 395 non-veterans with chronic hepatitis C; results were reported in the January
2007 Journal of Viral Hepatitis.
Study
participants completed a detailed questionnaire concerning medical, social, and
occupational issues. Clinical factors associated with progressive liver disease
were compared and fibrosis stage was assessed by liver
biopsy (available for 168 veterans and 208 non-veterans).
Results
•
Although the veterans were significantly older and had higher lifetime alcohol
consumption than non-veterans, their median fibrosis scores did not differ from
those of non-veterans.
•
By univariate analysis, alanine aminotransferase
(ALT) level, necroinflammatory activity, and cryoglobulin positivity were
associated with fibrosis in both veterans and non-veterans.
•Steatosis
(fat accumulation in the liver) was associated with fibrosis only in non-veterans.
•By
multivariate analysis, necroinflammatory activity was an independent risk factor
for fibrosis in both groups.
•However,
fibrosis in non-veterans was also independently associated with steatosis, significant
alcohol consumption, and age.
Conclusion
"Independent
risk factors for fibrosis vary
among high HCV prevalence groups such as veterans when compared with non-veterans,"
the researchers concluded. "Understanding specific patient cohort effects
is important for determining independent risk factors for disease progression
in chronic HCV infection."
02/06/07
Reference Z
Kayali, S Tan, L Shinkunas, and others. Risk factors for hepatitis C fibrosis:
a prospective study of United States veterans compared with nonveterans. Journal
of Viral Hepatitis 14(1): 11-21. January 2007.
