Predictive factors for development of cirrhosis in parenterally acquired chronic hepatitis C: a comparison between immunocompetent and immunocompromised patients

Background/Aims: The aim of this study was to evaluate the impact of the host immune status and of virological and environmental parameters on the development of cirrhosis during chronic hepatitis C virus infection. Methods: Liver histology (cirrhosis or not, Knodell score) was evaluated according t...

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Published in:Journal of hepatology 1998-07, Vol.29 (1), p.12-19
Main Authors: Pol, Stanislas, Fontaine, Hélène, Carnot, Françoise, Zylberberg, Hervé, Berthelot, Pierre, Bréchot, Christian, Nalpas, Bertrand
Format: Article
Language:English
Subjects:
Adult
Aged
AIDS/HIV
Biological and medical sciences
Cirrhosis
Female
Hepatitis C virus
Hepatitis C, Chronic - immunology
Hepatitis C, Chronic - pathology
Hepatitis C, Chronic - physiopathology
Human viral diseases
Humans
Immune deficiency
Immunocompetence
Immunocompromised Host
Infectious diseases
Liver Cirrhosis - epidemiology
Liver Cirrhosis - pathology
Liver Cirrhosis - virology
Male
Medical sciences
Middle Aged
Multivariate Analysis
Risk Factors
Viral diseases
Viral hepatitis
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Summary:Background/Aims: The aim of this study was to evaluate the impact of the host immune status and of virological and environmental parameters on the development of cirrhosis during chronic hepatitis C virus infection. Methods: Liver histology (cirrhosis or not, Knodell score) was evaluated according to age, sex, route and age of contamination, alcohol consumption and immune status in a large series of 553 HBsAg-negative patients (whose duration of hepatitis C virus infection could be precisely evaluated) divided into three groups: group 1 consisted of 462 immunocompetent subjects (46.1% intravenous drug users, 53.9% transfused), infected for a mean of 12.5±6.7 years, including 16.6% of alcohol abusers (>80 g/day); groups 2a and 2b consisted of 91 immunocompromised patients, 52 human immunodeficiency virus-coinfected patients corresponding to group 2a and 39 kidney recipients undergoing immunosuppressive therapy for group 2b, having been infected by hepatitis C virus for a mean of 12.6±5.3 and 11.5±5.3 years, respectively. Results: Group 1: cirrhosis was present in 11.0% of group 1 patients and in 23.6% of immunocompetent patients with a duration of hepatitis C virus infection of 20 years or more. Forty-three percent of patients with cirrhosis and with hepatitis C virus infection for more than 20 years were alcohol abusers. The time taken to develop cirrhosis was 14±7 years in patients infected before the age of 40 years as compared to 8±5 years in those infected after 40 years ( p
ISSN:0168-8278
1600-0641
DOI:10.1016/S0168-8278(98)80173-6