Patterns of progression

Tassopoulos, Nicolaos C.

doi:10.1007/bf02087875

Cited by 6 publications

(2 citation statements)

References 40 publications

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“…Factors influencing the rate of progression from chronic hepatitis to cirrhosis appear to include age at time of exposure, duration of infection, degree of previous liver damage, immunological system status, and HCV genotype. The disease progression is insidious; the clinically significant time of evolution varies: the diagnosis of chronic hepatitis, cirrhosis, and hepatocellular carcinoma have been estimated to be 10, 20, and 30 years, respectively [1, 5]. The majority of patients show increased levels of aminotransferases as well as hepatocellular damage.…”

Section: Introductionmentioning

confidence: 99%

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Noninvasive Monitoring of Hepatic Damage from Hepatitis C Virus Infection

Alavez-Ramírez

Fuentes-Allen

2011

Computational and Mathematical Methods in Medicine

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The mathematical model for the dynamics of the hepatitis C proposed in Avendaño et al. (2002), with four populations (healthy and unhealthy hepatocytes, the viral load of the hepatitis C virus, and T killer cells), is revised. Showing that the reduced model obtained by considering only the first three of these populations, known as basic model, has two possible equilibrium states: the uninfected one where viruses are not present in the individual, and the endemic one where viruses and infected cells are present. A threshold parameter (the basic reproductive virus number) is introduced, and in terms of it, the global stability of both two possible equilibrium states is established. Other central result consists in showing, by model numerical simulations, the feasibility of monitoring liver damage caused by HCV, avoiding unnecessary biopsies and the undesirable related inconveniences/imponderables to the patient; another result gives a mathematical modelling basis to recently developed techniques for the disease assessment based essentially on viral load measurements.

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Section: Introductionmentioning

confidence: 99%

“…The progression of the disease is variable, not always orderly nor sequential. Patients can evolve from chronic hepatitis directly to hepatocellular carcinoma without first developing cirrhosis, especially those with genotype 1b [5]. …”

Section: Introductionmentioning

confidence: 99%

Noninvasive Monitoring of Hepatic Damage from Hepatitis C Virus Infection

Alavez-Ramírez

Fuentes-Allen

2011

Computational and Mathematical Methods in Medicine

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Impact of alcohol on the histological and clinical progression of Hepatitis C infection

et al. 1998

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In patients infected with the hepatitis C virus (HCV), 20% to 30% will progress to cirrhosis in over two to three decades. Viral and host factors that are important in the clinical and histologic progression of HCV infection are not entirely certain. It has been suggested that liver disease is worse in alcoholics infected with HCV. In the present retrospective study, we examined the effect of moderate alcohol intake on the histologic and clinical progression of HCV infection and assessed whether other variables such as gender, length of exposure, mode of exposure, HCV RNA levels, and ferritin levels also independently impacted disease progression. Liver biopsies were analyzed for the degree of fibrosis, presence of cirrhosis, and histologic activity by using the Histologic Activity Index of Knodell. Patients were divided into two groups based on whether their alcohol intake was significant or not significant. Significant alcohol intake was defined as G40 g alcohol/day in women and G60 g of alcohol/day in men for G5 years. Groups were further divided based on the decades of exposure to HCV. There was no difference in the age or length of exposure to HCV in the alcohol and the alcoholfree group. HCV RNA serum levels, ferritin levels, and viral genotypes were similar in both groups. There was a two-to threefold greater risk of liver cirrhosis and decompensated liver disease in the alcohol group. Also, the rate to which subjects developed cirrhosis was faster in the alcohol group with 58% being cirrhotic by the second decade as opposed to 10% being cirrhotic in the nonalcohol group by the second decade. The histologic and clinical acceleration of liver disease was independent of the mode of exposure or sex. In summary, alcohol intake is an independent risk factor in the clinical and histologic progression of HCV infection. (HEPATOLOGY 1998;28:805-809.)In the United States 3 to 4 million people are infected with HCV. HCV infection is an indolent disease with patients rarely having clinical symptoms until cirrhosis develops. Ten to thirty percent of patients infected with HCV will develop cirrhosis over a 20 to 30 year period, and 1% to 5% will develop hepatocellular carcinoma. [1][2][3][4] Host and viral factors that are important in enhancing the progression to cirrhosis are not entirely clear. 5 Proposed contributory factors include viral genotype, circulating viral load, duration of infection, mode of infection, iron load, gender, and alcohol consumption. [1][2][3][4][5] It is recognized that 5% to 25% of chronic alcoholics with liver disease have a positive HCV antibody test. 6-12 Also, a number of studies have suggested that patients with alcoholic liver disease who are infected with the HCV have more impaired biochemical function and a greater chance of developing cirrhosis. [6][7][8][9][10][11][12] Alcohol intake has also been implicated as an independent risk factor in the progression of HCV, 13 although its overall effect on both the histologic and clinical progression of liver disease in patients chronicall...

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