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Impact of steatosis on progression of fibrosis in patients with mild hepatitis C.
Hepatology. 2005 Jan; 41(1):82-7.Hep

Abstract

In patients with mild hepatitis C, the usefulness of antiviral therapy is subject of debate, as a low risk for progression of fibrosis is assumed. Several studies have shown that steatosis is a strong and independent predictor of the severity as well as the progression of fibrosis in chronic hepatitis C. Therefore, this study assessed the impact of steatosis on the progression of fibrosis between paired liver biopsies in untreated patients with mild hepatitis on index biopsy. One hundred thirty-five untreated patients (mean age, 38 years; M/F sex ratio, 1.43) with one known risk factor of infection (68 transfusions, 67 injecting drug use) had 2 liver biopsies after a median interval of 61 months (18-158). All had METAVIR score of A1F1 or lower at first liver biopsy. Unequivocal progression of fibrosis was considered if patients had a fibrosis score of 3 or 4 at the second liver biopsy. The probability of progression of fibrosis was estimated by using the Kaplan-Meier method. During follow-up, progression of fibrosis occurred in 21 patients (16%) after a median delay of 65 months. Cumulative probabilities of the progression of fibrosis at 4 and 6 years were 5.2% and 19.8%, respectively. In multivariate analysis, steatosis was the only independent factor predictive of progression of fibrosis (RR, 4.8; CI, 1.3-18.3). Probability of progression of fibrosis was significantly related to the percentage of hepatocytes with steatosis. In conclusion, steatosis is a major determinant of the progression of fibrosis in mild hepatitis C, regardless of the genotype. Our results argue for antiviral treatment in the subgroup of patients with mild hepatitis and steatosis.

Authors+Show Affiliations

Service d'Hépatologie, Hôpital Saint-Antoine, Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15690484

Citation

Fartoux, Laetitia, et al. "Impact of Steatosis On Progression of Fibrosis in Patients With Mild Hepatitis C." Hepatology (Baltimore, Md.), vol. 41, no. 1, 2005, pp. 82-7.
Fartoux L, Chazouillères O, Wendum D, et al. Impact of steatosis on progression of fibrosis in patients with mild hepatitis C. Hepatology. 2005;41(1):82-7.
Fartoux, L., Chazouillères, O., Wendum, D., Poupon, R., & Serfaty, L. (2005). Impact of steatosis on progression of fibrosis in patients with mild hepatitis C. Hepatology (Baltimore, Md.), 41(1), 82-7.
Fartoux L, et al. Impact of Steatosis On Progression of Fibrosis in Patients With Mild Hepatitis C. Hepatology. 2005;41(1):82-7. PubMed PMID: 15690484.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of steatosis on progression of fibrosis in patients with mild hepatitis C. AU - Fartoux,Laetitia, AU - Chazouillères,Olivier, AU - Wendum,Dominique, AU - Poupon,Raoul, AU - Serfaty,Lawrence, PY - 2005/2/4/pubmed PY - 2005/2/16/medline PY - 2005/2/4/entrez SP - 82 EP - 7 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 41 IS - 1 N2 - In patients with mild hepatitis C, the usefulness of antiviral therapy is subject of debate, as a low risk for progression of fibrosis is assumed. Several studies have shown that steatosis is a strong and independent predictor of the severity as well as the progression of fibrosis in chronic hepatitis C. Therefore, this study assessed the impact of steatosis on the progression of fibrosis between paired liver biopsies in untreated patients with mild hepatitis on index biopsy. One hundred thirty-five untreated patients (mean age, 38 years; M/F sex ratio, 1.43) with one known risk factor of infection (68 transfusions, 67 injecting drug use) had 2 liver biopsies after a median interval of 61 months (18-158). All had METAVIR score of A1F1 or lower at first liver biopsy. Unequivocal progression of fibrosis was considered if patients had a fibrosis score of 3 or 4 at the second liver biopsy. The probability of progression of fibrosis was estimated by using the Kaplan-Meier method. During follow-up, progression of fibrosis occurred in 21 patients (16%) after a median delay of 65 months. Cumulative probabilities of the progression of fibrosis at 4 and 6 years were 5.2% and 19.8%, respectively. In multivariate analysis, steatosis was the only independent factor predictive of progression of fibrosis (RR, 4.8; CI, 1.3-18.3). Probability of progression of fibrosis was significantly related to the percentage of hepatocytes with steatosis. In conclusion, steatosis is a major determinant of the progression of fibrosis in mild hepatitis C, regardless of the genotype. Our results argue for antiviral treatment in the subgroup of patients with mild hepatitis and steatosis. SN - 0270-9139 UR - https://www.unboundmedicine.com/medline/citation/15690484/Impact_of_steatosis_on_progression_of_fibrosis_in_patients_with_mild_hepatitis_C_ L2 - https://doi.org/10.1002/hep.20519 DB - PRIME DP - Unbound Medicine ER -