Natural History of Hepatitis C in Patients with Severe Liver Fibrosis
As
reported in the July 2007 Journal of Hepatology, British researchers conducted
a study to examine the morbidity and mortality of patients with severe liver
fibrosis related to hepatitis C virus (HCV)
infection, within a population unbiased by tertiary referral.
A total
of 150 HCV positive patients were identified from the Trent HCV study who had
liver biopsies taken before 2002 that demonstrated severe fibrosis (Ishak stage
4). Follow-up data were extracted from the study database and hospital records.
The median follow-up period was 51 months.
Results
• Of the 131 patients with
no prior history of hepatic decompensation, 25% either died (n=25) or received
a liver transplant (n=8), after a median interval of 42 months.
•Hepatocellular carcinoma
(liver cancer) and/or hepatic decompensation were diagnosed in 33 patients (25%),
after a median interval of 41 months.
•
The probability of survival without liver
transplantation was 97% at 1 year, 88% at 3 years, and 78% at 5 years.
•
Overall, prognosis was not affected by Ishak stage on the initial biopsy.
• However, the 19 patients
with previous hepatic decompensation had worse prognosis: 89% either died (n=15)
or received a liver transplant (n=2).
Conclusion
In
conclusion, the authors wrote, "This study demonstrates that severe liver
fibrosis (Ishak stage 4) secondary to hepatitis C is associated with a poor prognosis,
that may be improved following combination antiviral treatment."
07/10/07
Reference A
Lawson, S Hagan, K Rye, and others. The natural history of hepatitis C with severe
hepatic fibrosis. Journal of Hepatology 47(1): 37-45. July 2007.
