Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients.
OBJECTIVE
Few data are available concerning the long-term prognosis of chronic liver disease associated with hepatitis C virus infection. This study examined the morbidity and survival of patients with compensated cirrhosis type C.


METHODS
A cohort of 384 European cirrhotic patients was enrolled at seven tertiary referral hospitals and followed up for a mean period of 5 years. Inclusion criteria were biopsy-proven cirrhosis, abnormal serum aminotransferase levels, absence of complications of cirrhosis, and exclusion of hepatitis A and B viruses and of metabolic, toxic, or autoimmune liver diseases.


RESULTS
Antibodies against hepatitis C virus were positive in 98% of 361 patients tested. The 5-year risk of hepatocellular carcinoma was 7% and that of decompensation was 18%. Death occurred in 51 patients (13%), with 70% dying of liver disease. Survival probability was 91% and 79% at 5 and 10 years, respectively. Two hundred five patients (53%) were treated with interferon alfa. After adjustment for clinical and serological differences at baseline between patients treated or not treated with interferon, the 5-year estimated survival probability was 96% and 95% for treated and untreated patients, respectively.


CONCLUSIONS
In this cohort of patients, life expectancy is relatively long, in agreement with the morbidity data showing a slowly progressive disease.
Fattovich
G
G
Istituto di Semeiotica e Nefrologia Medica, University of Verona, Italy.
Giustina
G
G
Degos
F
F
Tremolada
F
F
Diodati
G
G
Almasio
P
P
Nevens
F
F
Solinas
A
A
Mura
D
D
Brouwer
J T
JT
Thomas
H
H
Njapoum
C
C
Casarin
C
C
Bonetti
P
P
Fuschi
P
P
Basho
J
J
Tocco
A
A
Bhalla
A
A
Galassini
R
R
Noventa
F
F
Schalm
S W
SW
Realdi
G
G
D006528:Carcinoma, Hepatocellular; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000276:immunology / Q000401:mortality* / Q000628:therapy; D008113:Liver Neoplasms; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
D018937:Hepatitis C Antibodies; D016898:Interferon-alpha