Disease progression and the risk factor analysis for chronic hepatitis C.
OBJECTIVE
The present study aimed to assess the incidence of advanced cirrhotic complications and to identify the risk factors associated with such complications in chronic hepatitis C.


METHODS
The data of 1137 chronic hepatitis C patients were retrospectively reviewed. We analysed the incidence rate and risk factors for 'disease progression', as defined by the occurrence of an increase of at least 2 points in the Child-Pugh score, oesophageal/gastric variceal bleeding, spontaneous bacterial peritonitis, hepatic encephalopathy, death related to liver disease or development of hepatocellular carcinoma (HCC).


RESULTS
Of the 1137 patients enrolled for analysis, 490 patients received antiviral treatment. The overall annual incidence rate of disease progression was 0.8 and 3.7% for patients with and without antihepatitis C virus (anti-HCV) therapy respectively. The development of HCC was the most common cause of disease progression. In patients with anti-HCV therapy, treatment response, platelet level and aspartate aminotranferase:platelet ratio index (APRI) were independent factors associated with disease progression. For those without anti-HCV therapy, older age, male sex, diabetes, platelet level and APRI were independent factors for disease progression. APRI was strongest predictor for disease progression.


CONCLUSIONS
The present study demonstrated that the development of HCC was the most common cause of disease progression, and we also identified the risk factors associated with disease progression. Thus, patients at such risks need close monitoring for disease progression, and especially for detecting HCC. Moreover, the active application of antiviral therapy and efforts to improve the antiviral response are required.
Sinn
Dong Hyun
DH
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Paik
Seung Woon
SW
Kang
Pung
P
Kil
Jae Sook
JS
Park
Sang Un
SU
Lee
So-Young
SY
Song
Soon Mi
SM
Gwak
Geum-Youn
GY
Choi
Moon Seok
MS
Lee
Joon Hyoek
JH
Koh
Kwang Cheol
KC
Yoo
Byung Chul
BC
D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D018450:Disease Progression; D023381:Endpoint Determination; D016174:Hepacivirus / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
D000998:Antiviral Agents