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Natural history of hepatic fibrosis progression in chronic hepatitis C virus infection in India.
J Gastroenterol Hepatol. 2009 Apr; 24(4):581-7.JG

Abstract

BACKGROUND AND AIM

The rate of fibrosis progression per year can predict the time for the development of cirrhosis in chronic hepatitis C (CHC). We assessed the rate of fibrosis progression and the predictors of disease severity in Indian CHC patients.

METHODS

Of the 355 treatment-naïve, histologically-proven CHC patients, the precise duration of infection (from the time of exposure to HCV until liver biopsy) could be determined in 213 patients (age = 41.6 +/- 14.7 years, male : female = 139 : 74, genotype 3 = 75%). The rate of fibrosis progression per year was calculated. The correlation of the advanced degree of fibrosis and age, duration of infection, age at the onset of infection, sex, mode of infection, hepatitis C virus (HCV) genotype, histological activity index (HAI), and the presence of diabetes mellitus were studied.

RESULTS

The median rate of fibrosis progression per year was 0.25 (0.0-1.5) fibrosis units. The fibrosis progression rate was higher in patients who acquired infection at > 30 years of age, those < 30 years (0.33 vs 0.15; P < 0.001), and those who acquired HCV infection with a history of blood transfusion than with other modes of transmission (0.25 vs 0.19; P = 0.04). The median time to progress to cirrhosis was 16 years. The multivariate analysis found that the HAI score (odds ratio [OR]= 14.03; P < 0.001) and the duration of infection > 10 years (OR = 4.83; P < 0.001) correlated with severe liver disease (fibrosis > or = 3).

CONCLUSION

The median rate of fibrosis progression per year in Indian CHC patients is 0.25 fibrosis units. A higher HAI and longer duration of infection are associated with a significant risk of advanced liver disease, and merit early therapeutic interventions.

Authors+Show Affiliations

Department of Gastroenterology, G.B. Pant Hospital, New Dehli 110002, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19032460

Citation

Hissar, Syed S., et al. "Natural History of Hepatic Fibrosis Progression in Chronic Hepatitis C Virus Infection in India." Journal of Gastroenterology and Hepatology, vol. 24, no. 4, 2009, pp. 581-7.
Hissar SS, Kumar M, Tyagi P, et al. Natural history of hepatic fibrosis progression in chronic hepatitis C virus infection in India. J Gastroenterol Hepatol. 2009;24(4):581-7.
Hissar, S. S., Kumar, M., Tyagi, P., Goyal, A., Suneetha, P. V., Agarwal, S., Rastogi, A., Sakhuja, P., & Sarin, S. K. (2009). Natural history of hepatic fibrosis progression in chronic hepatitis C virus infection in India. Journal of Gastroenterology and Hepatology, 24(4), 581-7. https://doi.org/10.1111/j.1440-1746.2008.05649.x
Hissar SS, et al. Natural History of Hepatic Fibrosis Progression in Chronic Hepatitis C Virus Infection in India. J Gastroenterol Hepatol. 2009;24(4):581-7. PubMed PMID: 19032460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Natural history of hepatic fibrosis progression in chronic hepatitis C virus infection in India. AU - Hissar,Syed S, AU - Kumar,Manoj, AU - Tyagi,Pankaj, AU - Goyal,Ankur, AU - Suneetha,P V, AU - Agarwal,Sriram, AU - Rastogi,Archana, AU - Sakhuja,Puja, AU - Sarin,Shiv K, Y1 - 2008/11/20/ PY - 2008/11/27/pubmed PY - 2009/7/3/medline PY - 2008/11/27/entrez SP - 581 EP - 7 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 24 IS - 4 N2 - BACKGROUND AND AIM: The rate of fibrosis progression per year can predict the time for the development of cirrhosis in chronic hepatitis C (CHC). We assessed the rate of fibrosis progression and the predictors of disease severity in Indian CHC patients. METHODS: Of the 355 treatment-naïve, histologically-proven CHC patients, the precise duration of infection (from the time of exposure to HCV until liver biopsy) could be determined in 213 patients (age = 41.6 +/- 14.7 years, male : female = 139 : 74, genotype 3 = 75%). The rate of fibrosis progression per year was calculated. The correlation of the advanced degree of fibrosis and age, duration of infection, age at the onset of infection, sex, mode of infection, hepatitis C virus (HCV) genotype, histological activity index (HAI), and the presence of diabetes mellitus were studied. RESULTS: The median rate of fibrosis progression per year was 0.25 (0.0-1.5) fibrosis units. The fibrosis progression rate was higher in patients who acquired infection at > 30 years of age, those < 30 years (0.33 vs 0.15; P < 0.001), and those who acquired HCV infection with a history of blood transfusion than with other modes of transmission (0.25 vs 0.19; P = 0.04). The median time to progress to cirrhosis was 16 years. The multivariate analysis found that the HAI score (odds ratio [OR]= 14.03; P < 0.001) and the duration of infection > 10 years (OR = 4.83; P < 0.001) correlated with severe liver disease (fibrosis > or = 3). CONCLUSION: The median rate of fibrosis progression per year in Indian CHC patients is 0.25 fibrosis units. A higher HAI and longer duration of infection are associated with a significant risk of advanced liver disease, and merit early therapeutic interventions. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/19032460/Natural_history_of_hepatic_fibrosis_progression_in_chronic_hepatitis_C_virus_infection_in_India_ L2 - https://doi.org/10.1111/j.1440-1746.2008.05649.x DB - PRIME DP - Unbound Medicine ER -