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Predicting progressive hepatic fibrosis stage on subsequent liver biopsy in chronic hepatitis C virus infection.
J Viral Hepat. 2005 Jan; 12(1):74-80.JV

Abstract

Retrospective cross-sectional studies indicate that 20% with chronic hepatitis C virus (HCV) infection become cirrhotic within 20 years. Known risk factors for advanced hepatic fibrosis include age at time of infection, male sex, excess alcohol consumption and cytokine polymorphisms. Prospective study to assess and identify factors predictive of change in hepatic fibrosis stage in chronic HCV infection by interval protocol liver biopsy was performed. One hundred and five patients with paired liver biopsy specimens separated by a mean 41 months were recruited from a cohort of 823 HCV carriers. Five per cent developed worsening hepatic fibrosis by more than two stages. In 43% there was no change in fibrosis stage. Excessive alcohol intake currently (P = 0.037) or previously (P = 0.07) predicted progression. In contrast, always having a normal alanine transaminase (P = 0.038) and always being negative in serum for HCV RNA (P =0.067) predicted no progression. Three models were developed to predict outcome. Progressive fibrosis was predicted by baseline fibrosis (P = 0.018), steatosis (P = 0.02) and age (P = 0.017). The rate of progressive fibrosis was predicted by baseline fibrosis (P = 0.0002), steatosis (P =0.039) and lobular inflammation (P = 0.09). Fibrosis stage on the second biopsy was predicted by baseline fibrosis alone (P = 0.01). The rate of progression varies widely. Alcohol misuse is an important co-factor. Progressive fibrosis can be predicted at first liver biopsy, where baseline fibrosis is most critical, allowing targeted therapy for those with early disease and a significant risk of progression.

Authors+Show Affiliations

Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15655051

Citation

Collier, J D., et al. "Predicting Progressive Hepatic Fibrosis Stage On Subsequent Liver Biopsy in Chronic Hepatitis C Virus Infection." Journal of Viral Hepatitis, vol. 12, no. 1, 2005, pp. 74-80.
Collier JD, Woodall T, Wight DG, et al. Predicting progressive hepatic fibrosis stage on subsequent liver biopsy in chronic hepatitis C virus infection. J Viral Hepat. 2005;12(1):74-80.
Collier, J. D., Woodall, T., Wight, D. G., Shore, S., Gimson, A. E., & Alexander, G. J. (2005). Predicting progressive hepatic fibrosis stage on subsequent liver biopsy in chronic hepatitis C virus infection. Journal of Viral Hepatitis, 12(1), 74-80.
Collier JD, et al. Predicting Progressive Hepatic Fibrosis Stage On Subsequent Liver Biopsy in Chronic Hepatitis C Virus Infection. J Viral Hepat. 2005;12(1):74-80. PubMed PMID: 15655051.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predicting progressive hepatic fibrosis stage on subsequent liver biopsy in chronic hepatitis C virus infection. AU - Collier,J D, AU - Woodall,T, AU - Wight,D G D, AU - Shore,S, AU - Gimson,A E, AU - Alexander,G J M, PY - 2005/1/19/pubmed PY - 2005/4/1/medline PY - 2005/1/19/entrez SP - 74 EP - 80 JF - Journal of viral hepatitis JO - J Viral Hepat VL - 12 IS - 1 N2 - Retrospective cross-sectional studies indicate that 20% with chronic hepatitis C virus (HCV) infection become cirrhotic within 20 years. Known risk factors for advanced hepatic fibrosis include age at time of infection, male sex, excess alcohol consumption and cytokine polymorphisms. Prospective study to assess and identify factors predictive of change in hepatic fibrosis stage in chronic HCV infection by interval protocol liver biopsy was performed. One hundred and five patients with paired liver biopsy specimens separated by a mean 41 months were recruited from a cohort of 823 HCV carriers. Five per cent developed worsening hepatic fibrosis by more than two stages. In 43% there was no change in fibrosis stage. Excessive alcohol intake currently (P = 0.037) or previously (P = 0.07) predicted progression. In contrast, always having a normal alanine transaminase (P = 0.038) and always being negative in serum for HCV RNA (P =0.067) predicted no progression. Three models were developed to predict outcome. Progressive fibrosis was predicted by baseline fibrosis (P = 0.018), steatosis (P = 0.02) and age (P = 0.017). The rate of progressive fibrosis was predicted by baseline fibrosis (P = 0.0002), steatosis (P =0.039) and lobular inflammation (P = 0.09). Fibrosis stage on the second biopsy was predicted by baseline fibrosis alone (P = 0.01). The rate of progression varies widely. Alcohol misuse is an important co-factor. Progressive fibrosis can be predicted at first liver biopsy, where baseline fibrosis is most critical, allowing targeted therapy for those with early disease and a significant risk of progression. SN - 1352-0504 UR - https://www.unboundmedicine.com/medline/citation/15655051/Predicting_progressive_hepatic_fibrosis_stage_on_subsequent_liver_biopsy_in_chronic_hepatitis_C_virus_infection_ L2 - https://doi.org/10.1111/j.1365-2893.2005.00598.x DB - PRIME DP - Unbound Medicine ER -