Review article: chronic hepatitis C – natural history and cofactors

Alberti, Alberto; Vario, Alessandro; Ferrari, Annachiara; Pistis, R.

doi:10.1111/j.1365-2036.2005.02602.x

Cited by 70 publications

(46 citation statements)

References 34 publications

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“…Similar data are available for the United States, with a strong association between elevated alanine transaminase (ALT) values and risk factors for NASH [10,37]. Recent publications suggest that disease progression is strongly associated with alcohol intake, obesity, the metabolic syndrome and hepatic steatosis, all of which emphasise that the patient's age at the time of diagnosis seems to be related to the presence of these host factors [1,11,38]. We have shown here that disease progression is associated with higher BMI, higher age at time of diagnosis, and probably with risk factors that are more prevalent in men.…”

Section: Discussionmentioning

confidence: 55%

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Chronic hepatitis C in Austria, 1992–2006: genotype distribution and demographic factors

Maieron

Metz-Gercek

Hackl³

et al. 2010

Eurosurveillance

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Chronic hepatitis C is a leading cause of end-stage liver disease and, with a worldwide prevalence of up to 3%, is a pandemic infectious disease. Austria, like most western European countries can be considered as a low prevalence country. This analysis aimed to assess the distribution of hepatitis C virus (HCV) genotypes in patients with chronic HCV infection in Upper Austria. Between September 1992 and December 2006, we identified 1,318 consecutive patients who tested positive for HCV RNA. Genotyping was routinely performed in 1,239 of the 1,318 patients, and in a subgroup of 617 patients data on the source of transmission were collected. Additionally we obtained data on liver histology and body mass index in a subsample of 273 of the 617 patients. Hepatitis C genotypes 1, 2, 3, 4, 6 and co-infections were found in 80.4%, 4.5%, 12.3%, 2.7%, 0.1% and 0.2% of the patients, respectively. There was a highly significant age difference in relation to gender at the time of diagnosis of chronic hepatitis C, with women being older than men (men: 45.0 years; women: 49.3 years; p<0.0001). The number of new cases of chronic hepatitis C decreased substantially over the last decade, but although risk factors for obtaining HCV are well established, we did not find a decrease in the age of first diagnosis. Besides consistent screening in defined risk groups it is important to raise awareness for risk factors for HCV acquisition and liver disease progression.

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Section: Discussionmentioning

confidence: 55%

“…Thanks to antiviral treatment, 50% of patients with progressive hepatitis can be cured if the infection is diagnosed in time and treatment is available [1]. Cofactors such as alcohol intake, obesity and underlying liver-related diseases (e.g.…”

Section: Introductionmentioning

confidence: 99%

Chronic hepatitis C in Austria, 1992–2006: genotype distribution and demographic factors

Maieron

Metz-Gercek

Hackl³

et al. 2010

Eurosurveillance

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“…Although the prevalence of major causes of CLD remains stable, data from the National Health and Nutrition Examination Surveys show that nonalcoholic fatty liver disease will be a substantial burden on the prevalence of CLD in the United States (1). Advanced fibrosis, cirrhosis, and hepatocellular carcinoma develop in about 17%-55% of patients with HCV and 20%-40% of those with hepatitis B virus and nonalcoholic steatohepatitis (4)(5)(6). Although early fibrosis has been shown to be partly reversible, cirrhosis is, by definition, irreversible.…”

Section: Implication For Patient Carementioning

confidence: 99%

Shear-Wave Elastography for the Estimation of Liver Fibrosis in Chronic Liver Disease: Determining Accuracy and Ideal Site for Measurement

Samir¹,

Dhyani²,

Vij³

et al. 2015

Radiology

176

143

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).q RSNA, 2014 Purpose:To evaluate the accuracy of shear-wave elastography (SWE) for staging liver fibrosis in patients with diffuse liver disease (including patients with hepatitis C virus [HCV]) and to determine the relative accuracy of SWE measurements obtained from different hepatic acquisition sites for staging liver fibrosis. Materials and Methods:The institutional review board approved this single-institution prospective study, which was performed between January 2010 and March 2013 in 136 consecutive patients who underwent SWE before their scheduled liver biopsy (age range, 18-76 years; mean age, 49 years; 70 men, 66 women). Informed consent was obtained from all patients. SWE measurements were obtained at four sites in the liver. Biopsy specimens were reviewed in a blinded manner by a pathologist using METAVIR criteria. SWE measurements and biopsy results were compared by using the Spearman correlation and receiver operating characteristic (ROC) curve analysis. Results:SWE values obtained at the upper right lobe showed the highest correlation with estimation of fibrosis (r = 0.41, P , .001). Inflammation and steatosis did not show any correlation with SWE values except for values from the left lobe, which showed correlation with steatosis (r = 0.24, P = .004). Abbreviations: AUC = area under the ROC curve CI = confidence interval CLD = chronic liver disease DANA = difference between the mean fibrosis stage of advanced fibrosis and the mean fibrosis stage of nonadvanced fibrosis HCV = hepatitis C virus ROC = receiver operating characteristic SWE = shear-wave elastography Author contributions:Guarantors of integrity of entire study, A.E.S., M.D.; study concepts/study design or data acquisition or data analysis/ interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; manuscript final version approval, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, A.E.S., M.D., A.V., J.M.N., K.E.C.; clinical studies, A.E.S., A.V., A.K.B., J.M.N., K.E.C., R.T.C.; statistical analysis, M.D., E.F.H.; and manuscript editing, A.E.S., M.D., A.V., R.T.C. Funding:R.T.C. supported by the National Institutes of Health (grant DK078772).Conflicts of interest are listed at the end of this article. (1), with as many as 150 000 new cases diagnosed each year (2)-20% of which had cirrhosis at presentation. The multiple causes of CLD follow a common pathway of progressive liver fibrosis, ultimately culminating in cirrhosis. These include hepatitis C virus (HCV), hepatitis B virus, nonalcoholic fatty liver disease, and alcoholic liver disease (3). Although the prevalence of major causes of CLD remains stable, data from the National Health and Nutrition Examination Surveys show that nonalcoholic fatty liver disease will be a substantial burden on the prevalence of CLD in the United States (1). Advanced fibrosis, cirrhosis, and hepatocellular carcinoma develop in about 17%-55% of patients with HCV ...

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“…Data from the Brazilian Society of Hepatology obtained from Brazilian blood donors have shown a prevalence rate of HCV infection equal to 1.1%, with higher rates in the North and lower rates in the South of the country (2). Acute HCV infection is most often asymptomatic; 50-85% of these patients ultimately develop chronic hepatitis (3), and 20%-30% of HCV patients develop cirrhosis after 20-30 years of disease (4). In a recent study, John-Baptiste and cols., reported that 14.8% of the individuals who acquired HCV infection by intravenous drug use developed cirrhosis 20 years after being infected (5).…”

Section: Introductionmentioning

confidence: 99%

Insulin resistance in non-diabetic patients with chronic hepatitis C: what does it mean?

Souza

Pace²,

Chebli³

et al. 2011

Arq Bras Endocrinol Metab

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Objectives: To determine the prevalence of insulin resistance (IR) in non-diabetic patients with chronic hepatitis C, and to assess the association between IR, laboratory parameters and histological findings. Subjects and methods: Eighty-two patients had their serum analyzed for glucose, lipid profile, C-reactive protein (CRP), ferritin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), HOMA-IR, viral load and HCV genotype. Patients with HOMA-IR levels > 2.5 were considered as carriers of insulin resistance. Results: IR was observed in 27% of patients and was associated with age, waist circumference and body mass index. IR patients were more likely to have more advanced hepatic fibrosis and necroinflammatory activity, higher levels of aminotransferases and liver steatosis than patients without IR. Conclusions: Insulin resistance is often present in patients with chronic hepatitis C, and this parameter is associated with more advanced HCV-related hepatic fibrosis. Arq Bras Endocrinol Metab. 2011;55(6):412-8 Keywords Chronic hepatitis C; liver fibrosis; insulin resistance; HOMA-IR RESUMO Objetivos: Em portadores de hepatite crônica C não diabéticos, verificar a prevalência de resistência insulínica (RI) e analisar a associação desta com os parâmetros laboratoriais e histológicos. Sujeitos e métodos: Foram incluídos no estudo 82 pacientes, e amostras de sangue foram coletadas para determinação de glicose, perfil lipídico, alanina aminotransferase (ALT), aspartato aminotransferase (AST), ferritina, HOMA-IR, carga viral e genótipo do VHC. HOMA--IR superior a 2,5 foi considerado resistência insulínica. Resultados: RI foi observada em 27% dos pacientes e foi associada a idade, circunferência abdominal e índice de massa corpórea. Quando comparado a pacientes sem RI, aqueles com HOMA-IR superior a 2,5 apresentaram graus mais acentuados de fibrose hepática e atividade necroinflamatória, maiores níveis de aminotransferases e esteatose hepática mais frequente. Conclusões: É comum a presença de RI em portadores de hepatite crônica C e esta se associa com graus mais avançados de fibrose hepática induzida pelo vírus da hepatite C. Arq Bras Endocrinol Metab. 2011;55(6):412-8 Descritores

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Review article: chronic hepatitis C – natural history and cofactors

Cited by 70 publications

References 34 publications

Chronic hepatitis C in Austria, 1992–2006: genotype distribution and demographic factors

Chronic hepatitis C in Austria, 1992–2006: genotype distribution and demographic factors

Shear-Wave Elastography for the Estimation of Liver Fibrosis in Chronic Liver Disease: Determining Accuracy and Ideal Site for Measurement

Insulin resistance in non-diabetic patients with chronic hepatitis C: what does it mean?

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