Natural history of decompensated hepatitis C virus-related cirrhosis. A study of 200 patients.
OBJECTIVE
Since few data are available concerning the clinical course of decompensated hepatitis C virus (HCV)-related cirrhosis, the aim of the present study was to define the natural long-term course after the first hepatic decompensation.


METHODS
Cohort of 200 consecutive patients with HCV-related cirrhosis, and without known hepatocellular carcinoma (HCC), hospitalized for the first hepatic decompensation.


RESULTS
Ascites was the most frequent first decompensation (48%), followed by portal hypertensive gastrointestinal bleeding (PHGB) (32.5%), severe bacterial infection (BI) (14.5%) and hepatic encephalopathy (HE) (5%). During follow-up (34+/-2 months) there were 519 readmissions, HCC developed in 33 (16.5%) patients, and death occurred in 85 patients (42.5%). The probability of survival after diagnosis of decompensated cirrhosis was 81.8 and 50.8% at 1 and 5 years, respectively. HE and/or ascites as the first hepatic decompensation, baseline Child-Pugh score, age, and presence of more than one decompensation during follow-up were independently correlated with survival.


CONCLUSIONS
Once decompensated HCV-related cirrhosis was established, patients showed not only a very high frequency of readmissions, but also developed decompensations different from the initial one. These results contribute to defining the natural course and prognosis of decompensated HCV-related cirrhosis.
Planas
Ramon
R
Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Universitat Autónoma de Barcelona, Badalona, Spain. rplanas@ns.hugtip.scs.es
Ballesté
Belén
B
Alvarez
Marco Antonio
MA
Rivera
Monica
M
Montoliu
Silvia
S
Galeras
Josep Anton
JA
Santos
Justiniano
J
Coll
Susanna
S
Morillas
Rosa Maria
RM
Solà
Ricard
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology; D001424:Bacterial Infections / Q000209:etiology; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006501:Hepatic Encephalopathy / Q000209:etiology; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D008103:Liver Cirrhosis / Q000209:etiology* / Q000401:mortality; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate