title: How severe is chronic hepatitis with HCV genotype 1b? A study of 1,220 cases on the waiting list for antiviral therapy in Romania.
abstract: BACKGROUND
  Chronic HCV infection represents a public health problem in Romania, with a prevalence of 3.23-4.56%, and more than 5,000 patients on the waiting lists for antiviral therapy.
  
  
  OBJECTIVE
  To perform an evaluation of the severity of chronic HCV infection genotype 1b, and a quantification of patients with a low viral load, in order to quantify the number of patients who may be considered for shortened treatment duration.
  
  
  METHODS
  Histological assessment and viral load were performed in 1,220 consecutive patients from the waiting list for antiviral therapy in 2009. The severity of chronic hepatitis was assessed by histological evaluation (the necrotic-inflammatory index - Metavir and the fibrosis score - Metavir). Viral load was measured by PCR and 400,000 UI/ml and 600,000 UI/ml were defined as thresholds for low versus high viral load We assessed the influence of age, sex, and viral load on necro-inflammatory activity and fibrosis.
  
  
  RESULTS
  The mean age of the patients included was 48 ± 10.69 years and females predominated (58%). Many of them (60%) were in stage F3, with a high potential for disease progression in the next 10 years (necro-inflammatory activity was moderate to severe in over 90%). Almost half of the patients had low viral load, below 600,000 copies/ml. The viral load was significantly associated with the age (p< 0.001) and sex (p< 0.001) of the patients.
  
  
  CONCLUSIONS
  Chronic HCV hepatitis in patients on the waiting lists for antiviral therapy in Romania has a high severity with important predictable consequences on the duration of life, complications and treatment costs. The strategy of shortening the duration of treatment would be beneficial for almost 50% of the patients.
authors: Regional Institute of Gastroenterology and Hepatology, 400162, Croitorilor Str. 19-21, Cluj-Napoca,Romania. opascu@umfcluj.ro
authors: Oliviu
authors: O
authors: Pascu
authors: Liana
authors: L
authors: Gheorghe
authors: Mihai
authors: M
authors: Voiculescu
authors: Emanoil
authors: E
authors: Ceausu
authors: Bogdan
authors: B
authors: Mateescu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012383:Romania; D019562:Viral Load; D014850:Waiting Lists