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Natural history of hepatitis C virus infection: from chronic hepatitis to cirrhosis, to hepatocellular carcinoma.
Minerva Gastroenterol Dietol 2005; 51(1):31-46MG

Abstract

Hepatitis C is a heterogeneous disease and is responsible for considerable mortality and morbidity. The hepatitis C virus (HCV) infects nearly 170 million people world-wide. More than 80% of infected individuals develop chronic infection; the remaining 10-20% develop spontaneous clearance with natural immunity. Acute hepatitis is icteric in only 20% of patients and is rarely severe. The majority of patients who develop chronic HCV infection are asymptomatic; but 60-80% develop chronic hepatitis as indicated by elevated alanine aminotransferase (ALT), around 30% maintain persistently normal ALT levels despite having detectable HCV-RNA in serum. One-third of chronically infected patients develop progressive liver injury, fibrosis and cirrhosis over a period of 20-30 years. The relationship between virus load, HCV genotype, quasi-species variability and progression of liver disease is controversial. Acquired infection after age 40, male sex, excessive alcohol-consumption, hepatitis B virus (HBV) or HIV co-infection, steatosis, and immunosuppressed state have been identified as co-factors associated with progression of fibrosis and development of cirrhosis. In patients with cirrhosis, the incidence of hepatocellular carcinoma is 2-5% per year. At present, HCV-related end-stage cirrhosis is the first cause of liver transplantation.

Authors+Show Affiliations

Molinette Hospital, Turin, Italy. leone.nic@tiscalinet.itNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng ita

PubMed ID

15756144

Citation

Leone, N, and M Rizzetto. "Natural History of Hepatitis C Virus Infection: From Chronic Hepatitis to Cirrhosis, to Hepatocellular Carcinoma." Minerva Gastroenterologica E Dietologica, vol. 51, no. 1, 2005, pp. 31-46.
Leone N, Rizzetto M. Natural history of hepatitis C virus infection: from chronic hepatitis to cirrhosis, to hepatocellular carcinoma. Minerva Gastroenterol Dietol. 2005;51(1):31-46.
Leone, N., & Rizzetto, M. (2005). Natural history of hepatitis C virus infection: from chronic hepatitis to cirrhosis, to hepatocellular carcinoma. Minerva Gastroenterologica E Dietologica, 51(1), pp. 31-46.
Leone N, Rizzetto M. Natural History of Hepatitis C Virus Infection: From Chronic Hepatitis to Cirrhosis, to Hepatocellular Carcinoma. Minerva Gastroenterol Dietol. 2005;51(1):31-46. PubMed PMID: 15756144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Natural history of hepatitis C virus infection: from chronic hepatitis to cirrhosis, to hepatocellular carcinoma. AU - Leone,N, AU - Rizzetto,M, PY - 2005/3/10/pubmed PY - 2005/6/4/medline PY - 2005/3/10/entrez SP - 31 EP - 46 JF - Minerva gastroenterologica e dietologica JO - Minerva Gastroenterol Dietol VL - 51 IS - 1 N2 - Hepatitis C is a heterogeneous disease and is responsible for considerable mortality and morbidity. The hepatitis C virus (HCV) infects nearly 170 million people world-wide. More than 80% of infected individuals develop chronic infection; the remaining 10-20% develop spontaneous clearance with natural immunity. Acute hepatitis is icteric in only 20% of patients and is rarely severe. The majority of patients who develop chronic HCV infection are asymptomatic; but 60-80% develop chronic hepatitis as indicated by elevated alanine aminotransferase (ALT), around 30% maintain persistently normal ALT levels despite having detectable HCV-RNA in serum. One-third of chronically infected patients develop progressive liver injury, fibrosis and cirrhosis over a period of 20-30 years. The relationship between virus load, HCV genotype, quasi-species variability and progression of liver disease is controversial. Acquired infection after age 40, male sex, excessive alcohol-consumption, hepatitis B virus (HBV) or HIV co-infection, steatosis, and immunosuppressed state have been identified as co-factors associated with progression of fibrosis and development of cirrhosis. In patients with cirrhosis, the incidence of hepatocellular carcinoma is 2-5% per year. At present, HCV-related end-stage cirrhosis is the first cause of liver transplantation. SN - 1121-421X UR - https://www.unboundmedicine.com/medline/citation/15756144/Natural_history_of_hepatitis_C_virus_infection:_from_chronic_hepatitis_to_cirrhosis_to_hepatocellular_carcinoma_ L2 - http://www.diseaseinfosearch.org/result/3332 DB - PRIME DP - Unbound Medicine ER -