title: Rate of natural disease progression in patients with chronic hepatitis C.
abstract: 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.
authors.affiliation: Département d'Hépato-gastroentérologie, CHU de Grenoble, BP 217, 38043 Grenoble Cedex 9, France. jpzarski@chu-grenoble.fr
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Zarski
authors.forename: John
authors.initials: J
authors.lastname: Mc Hutchison
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bronowicki
authors.forename: Nathalie
authors.initials: N
authors.lastname: Sturm
authors.forename: Richard
authors.initials: R
authors.lastname: Garcia-Kennedy
authors.forename: Enkelejda
authors.initials: E
authors.lastname: Hodaj
authors.forename: Brenda
authors.initials: B
authors.lastname: Truta
authors.forename: Teresa
authors.initials: T
authors.lastname: Wright
authors.forename: Robert
authors.initials: R
authors.lastname: Gish
mesh_terms: 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