Prevalence of hepatitis C-related cirrhosis in elderly Asian patients infected in childhood.
OBJECTIVE
Approximately 20% of hepatitis C virus (HCV) patients develop cirrhosis from infection after about 20 years. The proportion of patients developing cirrhosis for longer than 30 years after infection is unknown. Our objectives were to determine the prevalence of HCV-related cirrhosis in a population of Asian patients who were infected in childhood 20 to 80 years ago and compare this with the prevalence of cirrhosis in Caucasian patients referred to the same hospitals.


METHODS
Retrospective analyses were performed of all patients who had detectable HCV-RNA levels and who attended local hospitals in northeast London between 1992 and 2003. Factors implicated in the development of cirrhosis were examined by multivariable analysis.


RESULTS
A total of 143 adult Asian patients who had been infected with HCV for many decades were compared with 239 Caucasian patients. The prevalence of cirrhosis increased with age. Of Asian patients aged 61-80 years (n = 55) 78% had cirrhosis, whereas 25% of Caucasian patients aged 61-80 years (n = 55) had cirrhosis. Multivariable linear analysis revealed that fibrosis progression and age were similar in both groups and the difference in the prevalence of cirrhosis was not explained by any unique Asian characteristic other than prolonged infection.


CONCLUSIONS
The prevalence of cirrhosis in patients with chronic HCV increases with increasing duration of infection. In Asian patients infected at birth, infection for over 60 years causes cirrhosis in 71% of infected individuals. Because relationship between the severity of fibrosis and age in Asian patients is similar to that seen in Caucasian patients it is likely that similar rates of cirrhosis will be seen in other patients who are infected for more than 60 years.
D'Souza
Raymond
R
Hepatobiliary Group, Department of Adult and Pediatric Gastroenterology, Barts and The London, Queen Mary's School of Medicine and Dentistry, London, United Kingdom.
Glynn
Michael J
MJ
Ushiro-Lumb
Ines
I
Feakins
Roger
R
Domizio
Paolo
P
Mears
Lisa
L
Alsced
Elspeath
E
Kumar
Parvar
P
Sabin
Caroline A
CA
Foster
Graham R
GR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000821:virology*; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D044465:White People / Q000706:statistics & numerical data