Natural history and predictors of disease severity in chronic hepatitis C.
Cirrhosis is the end-stage consequence of fibrosis progression in patients with chronic hepatitis C. The median time from infection to cirrhosis is 30 years, with a high inter-individual variability, which is now better understood. Several factors have been clearly shown to be associated with fibrosis progression rate: duration of infection, age, male gender, alcohol consumption, HIV co-infection and low CD4 count. Metabolic conditions such as steatosis, being overweight and diabetes are emerging as independent co-factors of fibrogenesis. The recent validation of non-invasive biomarkers should facilitate the study of fibrosis progression in large populations.
Massard
Julien
J
Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France.
Ratziu
Vlad
V
Thabut
Dominique
D
Moussalli
Joseph
J
Lebray
Pascal
P
Benhamou
Yves
Y
Poynard
Thierry
T
D018450:Disease Progression; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index