Prevalence of liver disease in a population of asymptomatic persons with hepatitis C virus infection.
BACKGROUND
The prevalence of significant liver disease in persons with asymptomatic hepatitis C virus (HCV) infection is unclear.


OBJECTIVE
To determine the prevalence and severity of HCV infection in asymptomatic persons.


METHODS
Population-based cross-sectional study.


METHODS
Northeastern Italy.


METHODS
4820 apparently healthy Telecom Italy employees or their relatives who underwent screening for cardiovascular risk factors.


METHODS
Initial screening for anti-HCV by enzyme-linked immunosorbent assay followed by HCV RNA testing by polymerase chain reaction and monitoring of alanine aminotransferase levels in viremic persons (92% of viremic persons also had liver biopsies to assess their METAVIR scores).


RESULTS
116 persons (2.4% [95% CI, 1.97% to 2.84%]) were positive for anti-HCV and 85 (1.76% [CI, 1.39% to 2.14%]) were also viremic. The ALT level was persistently normal in 39 (46%) of viremic patients and elevated in 46 (54%). Significant hepatic histologic abnormalities were detected in 19% (CI, 7.21% to 36.4%) of persons with persistently normal ALT levels and in 61% (CI, 45.4% to 74.9%) of viremic persons who had elevated ALT levels (P < 0.001). The prevalence of HCV infection and number of persons with chronic liver fibrosis increased with age (P = 0.003).


CONCLUSIONS
Hepatitis C is histologically active and progressive in up to 40% of asymptomatic persons with HCV infection. The severity of liver disease correlates with abnormal ALT levels and increases with age.
Alberti
Alfredo
A
Department of Clinical and Experimental Medicine, Clinica Medica 5, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. alfredo.alberti@unipd.it
Noventa
Franco
F
Benvegnù
Luisa
L
Boccato
Silvia
S
Gatta
Angelo
A
D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D001706:Biopsy; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000150:complications* / Q000473:pathology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000473:pathology; D008107:Liver Diseases / Q000150:complications* / Q000453:epidemiology*; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood; D014766:Viremia / Q000150:complications* / Q000473:pathology
D006508:Hepatitis Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase