title: Progression of fibrosis in untreated patients with hepatitis C virus infection.
abstract: METHODS
  In order to evaluate the progression of liver fibrosis associated with Hepatitis C virus (HCV) infection, two liver biopsy specimens obtained prior to antiviral therapy from 98 patients with HCV were scored and evaluated using statistical methods appropriate for ordered categorical data.
  
  
  CONCLUSIONS
  Greater progression of fibrosis was seen with increasing time between the biopsies. Likewise, the change in fibrosis score was significantly more pronounced in the 11 patients whose first biopsy was obtained within the first year after acquiring HCV. A multivariate logistic regression analysis of possible explanatory factors for the fibrosis outcome showed that interface hepatitis in both biopsies, the time interval between the biopsies, and age at first biopsy were associated with change in the fibrosis score. In addition we found that higher age at the time of infection was associated with development of cirrhosis, that moderate intake of alcohol was associated with fibrosis progression, and that an inflammatory response in the form of moderate interface hepatitis in the first biopsy was not necessarily associated with greater progression of fibrosis if the second biopsy showed mild interface hepatitis. However, having moderate interface hepatitis later in the course of infection as reflected by the second biopsy may be detrimental. If moderate interface hepatitis early in the course of the disease is followed by less interface hepatitis later there is less fibrosis; and if moderate interface hepatitis persists, there is more fibrosis eventually.
authors.affiliation: Department of Clinical Virology, Göteborg University, Göteborg, Sweden, Department of Infectious Diseases, Göteborg University, Sweden. martin.lagging@medfak.gu.se
authors.forename: L Martin
authors.initials: LM
authors.lastname: Lagging
authors.forename: Johan
authors.initials: J
authors.lastname: Westin
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Svensson
authors.forename: Nibia
authors.initials: N
authors.lastname: Aires
authors.forename: Amar P
authors.initials: AP
authors.lastname: Dhillon
authors.forename: Magnus
authors.initials: M
authors.lastname: Lindh
authors.forename: Rune
authors.initials: R
authors.lastname: Wejstål
authors.forename: Gunnar
authors.initials: G
authors.lastname: Norkrans
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D004279:DNA, Viral