Natural history of hepatitis C: Its impact on clinical management

Bisceglie, Adrian M. Di

doi:10.1053/he.2000.5762

Cited by 254 publications

(177 citation statements)

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“…9 This duration has been confirmed further by several investigators in other countries. 1 Our data, which indicated a duration of 31 years (standard deviation of 8 years) (n ϭ 52) between a blood transfusion and the appearance of clinical HCC, are consistent with those found in previous studies. To our knowledge, there have been a number of reports regarding the cumulative probability of HCC development in HCV-infected patients.…”

Section: Discussionsupporting

confidence: 92%

“…The interval between HCV infection and the development of significant liver disease is reported to be very long. 1 Kiyosawa et al reported that the mean duration between blood transfusion and the diagnosis of HCC was approximately 29 years (standard deviation of 13 years) (n ϭ 21), 5 and Tong et al reported it to be 28 years (standard deviation of 11 years) (n ϭ 14). 9 This duration has been confirmed further by several investigators in other countries.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Some authors emphasize the apparently low rate of clinically significant liver disease due to posttransfusion hepatitis C, whereas others focus on the alarming number of patients with end-stage liver disease. 2 This apparent paradox has been only partly resolved.…”

mentioning

confidence: 99%

“…In the patients with posttransfusion hepatitis C, sustained clearance of serum HCV-RNA was observed in 15-20% of patients. 1,3 Among those patients who go on to develop chronicity, the majority remain asymptomatic for years. Some of the patients with chronic hepatitis C were found to have compensated cirrhosis.…”

mentioning

confidence: 99%

“…Some of the patients with chronic hepatitis C were found to have compensated cirrhosis. 1,2 Other patients with chronic HCV infection appear to have persistently normal serum transaminase levels. 4 It is important to prognosticate accurately any given patient's likelihood of developing clinically serious or fatal complications, such as cirrhosis and HCC, for the screening and treatment of these potentially devastating diseases.…”

mentioning

confidence: 99%

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Impact of aging on the development of hepatocellular carcinoma in patients with posttransfusion chronic hepatitis C

Hamada

Yatsuhashi

Yano

et al. 2002

Cancer

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BACKGROUNDHepatitis C virus (HCV) infection is a heterogeneous disease, the natural history of which remains controversial. There is solid evidence that chronic HCV infection is responsible for the occurrence of hepatocellular carcinoma (HCC). The aim of the current cohort study was to determine the rate of the development of HCC from the time of primary HCV infection and to assess the risk factors for the development of HCC in chronic posttransfusion hepatitis C patients.METHODSFour hundred sixty‐nine patients with clinically compensated HCV, who had undergone a single blood transfusion comprised the current study cohort. Patients with other risk factors for chronic liver disease were excluded. All patients were referred to the liver center at the National Nagasaki Medical Center between December 1980 and December 1998 and were followed prospectively until the end of the analysis (June 2000).RESULTSFollow‐up data were obtained for 445 patients. The mean duration from HCV infection to the end of the observation was 28 years. Fifty‐two patients (11.1%) progressed to HCC. The mean duration from the time of blood transfusion to the diagnosis of HCC was 31 years. Multivariate Cox regression analyses revealed age, fibrosis, duration from HCV infection to study entry, and alcohol consumption to be the independent factors affecting the development of HCC. The risk of developing HCC in patients age ≥ 56 years was increased 7.8‐fold compared with that in patients age < 56 years. The mean age of patients at the time of HCC diagnosis was 65 years (range, 58–79 years).CONCLUSIONSAt the time of diagnosis, 92% of the 52 HCC patients were age > 60 years and 38 of the HCC patients (73%) were in their 60s. There was a significantly negative correlation between the duration from HCV infection to the development of HCC and the age of the patient at the time of infection (correlation coefficient = 0.702; P < 0.0001; Y = 61.1–0.82X), indicating that the age of patients, rather than the duration of HCV infection, is more significant for HCC development in patients with posttransfusion HCV. Moreover, these data may contribute to the design of an optimal follow‐up schedule for patients with posttransfusion HCV. Cancer 2002;95:331–9. © 2002 American Cancer Society.DOI 10.1002/cncr.10662

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Section: Discussionsupporting

confidence: 92%