Changes in hepatitis C-related liver disease in a large clinic population.
BACKGROUND
Hepatitis C virus (HCV) infection is a significant problem in the Australian community. Over the past few years, the number of patients with diagnosed hepatitis C has increased greatly. The aims of the present study were to define the clinical features of a large group of patients with chronic HCV infection and to examine changes occurring in the referral base and epidemiological characteristics of this group since analysis of the first 342 patients in 1994.


METHODS
The study included 1,546 consecutive anti-HCV-positive patients who had been referred to St Vincent's Hospital from January 1990 to June 1998. Clinical and laboratory data were collected on all patients.


RESULTS
Referrals from general practitioners increased from 31% to 70% of all patients between 1990-1993 and 1994-1998. A history of injecting drug use (IDU) was present in 64% of the patients. While 89% of the IDU group was Australasian born, 49% of those in the sporadic group were born overseas. Cirrhosis was found in 18% of biopsied patients. Age, infection duration, age at infection, Mediterranean or Asian origin and a history of transfusion or lack of HCV risk factors were associated with cirrhosis on univariate analysis. Patient age was the only independent predictor of cirrhosis.


CONCLUSIONS
The majority of patients with HCV are diagnosed in general practice. A risk factor for infection is identified in 82% of patients. While our reported prevalence of cirrhosis may be an overestimate of that in the overall HCV community, the ultimate disease burden is likely to be significant.
Ostapowicz
G
G
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
Dallinger
M
M
Bell
S J
SJ
Strasser
S I
SI
Watson
K J
KJ
Slavin
J
J
Santamaria
J
J
Desmond
P V
PV
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001315:Australia / Q000453:epidemiology; D001706:Biopsy / Q000379:methods; D016001:Confidence Intervals; D005260:Female; D018937:Hepatitis C Antibodies / Q000097:blood*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012017:Referral and Consultation / Q000706:statistics & numerical data; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology
D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase