Rate of natural disease progression in patients with chronic hepatitis C.
OBJECTIVE
The interval at which liver biopsy should be repeated in untreated patients with chronic hepatitis C is not defined. We examined fibrosis change by METAVIR scoring in these patients in whom two or more liver biopsies were available.


METHODS
One hundred and eighty patients with histologically proven chronic hepatitis C were studied. Mean delay between biopsies was 3.67+/-2.69 years and 3.08+/-1.43 in the 16 patients having three biopsies. Univariate and multivariate analyses were performed to determine factors associated with liver fibrosis progression.


RESULTS
Median rate of fibrosis progression per year was 0.04 (0.00-0.55) to first biopsy, 0.00 (-0.84-1.02) between first and second biopsy (NS), and 0.17 (0.00-1.50) between second and third biopsy (P<0.05). In multivariate analysis, only age at first biopsy >40 years (OR=5) (2-12) and alcohol consumption of 1-50 g per day (OR=4) (2-12) and more than 50 g per day (OR=8) (3-23) were associated with severe fibrosis. The number of patients who increased in fibrosis stage was significantly higher after 4 years (P<0.02).


CONCLUSIONS
An interval of at least 4-5 years is needed between liver biopsies to measure change in patients with mild liver disease.
Zarski
Jean-Pierre
JP
Département d'Hépato-gastroentérologie, CHU de Grenoble, BP 217, 38043 Grenoble Cedex 9, France. jpzarski@chu-grenoble.fr
Mc Hutchison
John
J
Bronowicki
Jean-Pierre
JP
Sturm
Nathalie
N
Garcia-Kennedy
Richard
R
Hodaj
Enkelejda
E
Truta
Brenda
B
Wright
Teresa
T
Gish
Robert
R
D000328:Adult; D000428:Alcohol Drinking; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D005602:France / Q000208:ethnology; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000208:ethnology / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D014481:United States