title: Long-term follow-up of the hepatitis C HENCORE cohort: response to therapy and occurrence of liver-related complications.
abstract: The aims of the study were to verify the long-term effect of time on viral clearance in hepatitis C virus (HCV) patients and to find out factors possibly associated with disease progression. A total of 1641 patients recruited from eight European centres in 1996-1997 were re-analysed 5-7 years after inclusion. The occurrence of decompensated cirrhosis, hepatocellular carcinoma (HCC) and liver transplantation was analysed in relation to different host and viral factors. Ninety-three per cent of the HCV patients who had cleared the virus (spontaneously or after antiviral therapy) remained HCV-RNA-negative during follow up and may be considered as 'cured'. Among patients who were sustained responders at inclusion, 2.3% developed liver complications during follow up, and 31% of non-responders did. Advanced age at infection and presence of the human leucocyte antigen (HLA) DRB1*1201-3 allele were possibly associated with a higher rate of progression to decompensated cirrhosis or HCC. Decompensated cirrhosis might be further associated with male gender, non-response to previous therapy, and lack of HLA DRB1*1301 allele, whereas HCC seems to be associated with the presence of the HLA DQ02 allele. Long-term follow up of HCV patients indicates that virological response persists over time and is associated with a very low incidence of liver complications. Advanced age at inclusion, advanced age at infection, viral genotype 1, non-response to previous therapy and possibly some specific HLA alleles are factors independently associated with a faster rate of progression towards liver complications. The large proportion of patients lost to follow up stresses the need for a strengthened and optimized management of HCV patients.
authors.affiliation: Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France. pradat@univ-lyon1.fr
authors.forename: P
authors.initials: P
authors.lastname: Pradat
authors.forename: H L
authors.initials: HL
authors.lastname: Tillmann
authors.forename: S
authors.initials: S
authors.lastname: Sauleda
authors.forename: J-H
authors.initials: JH
authors.lastname: Braconier
authors.forename: G
authors.initials: G
authors.lastname: Saracco
authors.forename: M
authors.initials: M
authors.lastname: Thursz
authors.forename: R
authors.initials: R
authors.lastname: Goldin
authors.forename: R
authors.initials: R
authors.lastname: Winkler
authors.forename: A
authors.initials: A
authors.lastname: Alberti
authors.forename: J-I
authors.initials: JI
authors.lastname: Esteban
authors.forename: S
authors.initials: S
authors.lastname: Hadziyannis
authors.forename: M
authors.initials: M
authors.lastname: Rizzetto
authors.forename: H
authors.initials: H
authors.lastname: Thomas
authors.forename: M P
authors.initials: MP
authors.lastname: Manns
authors.forename: C
authors.initials: C
authors.lastname: Trepo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000254:growth & development*; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006651:Histocytochemistry; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology*; D008113:Liver Neoplasms / Q000821:virology*; D008297:Male; D008875:Middle Aged