title: Natural history of hepatitis C virus infection in a cohort of asymptomatic post-transfused subjects.
abstract: BACKGROUND & AIMS. Studies about the natural history of hepatitis C virus (HCV) infection report variable progression to cirrhosis depending on study design. Retrospective cross-sectional liver clinic studies overestimate the rate of fibrosis progression due to inclusion of patients with more severe disease leaving mild and asymptomatic patients underrepresented. We evaluated fibrosis progression in a group of "healthy" asymptomatic subjects, attending to a voluntary campaign for the detection of HCV infection.
  
  
  METHODS
  A detection campaign was launched on subjects transfused before 1993. Of 1699 volunteers, 61(3.6%) had HCV infection. A liver biopsy was performed in 40 (65%). Assessed risk factors for liver fibrosis were: sex, body mass index, alcohol consumption (> 20 g/d - > 40g/d ), genotype, HLA-DRB1 alleles, present age, age at infection and duration of infection.
  
  
  RESULTS
  25 (62.5%) were women with a median age of 52.5 years. The median duration of infection was 21.5 years with a median age at infection of 27 years. As regards fibrosis, 25 (62.5%) had a Low Stage (F0-F1), 8 patients, 20%, had severe fibrosis, one patient (2.5%) had cirrhosis. Alcohol consumption was the only risk factor associated with fibrosis progression.
  
  
  CONCLUSIONS
  The low progression to cirrhosis may be explained by the clinical characteristics of our population: asymptomatic middle-aged "healthy" subjects infected at young age. The progression to severe fibrosis was noticeable; hence a longer follow-up might demonstrate changes in this outcome. Significant alcohol consumption clearly worsens the natural history of HCV infection; this is no so evident for occasional or mild alcohol consumers.
authors.affiliation: Gastroenterology and Hepatology Department, Hospital Provincial del Centenario, School of Medicine, University of Rosario, Argentina. mvregiardo@ciudad.com.ar
authors.forename: María Virginia
authors.initials: MV
authors.lastname: Reggiardo
authors.forename: Fabián
authors.initials: F
authors.lastname: Fay
authors.forename: Mario
authors.initials: M
authors.lastname: Tanno
authors.forename: Gabriela
authors.initials: G
authors.lastname: García-Camacho
authors.forename: Oscar
authors.initials: O
authors.lastname: Bottaso
authors.forename: Sebastián
authors.initials: S
authors.lastname: Ferretti
authors.forename: Alicia
authors.initials: A
authors.lastname: Godoy
authors.forename: Claudio
authors.initials: C
authors.lastname: Guerrita
authors.forename: Mauro
authors.initials: M
authors.lastname: Paez
authors.forename: Federico
authors.initials: F
authors.lastname: Tanno
authors.forename: Orlando
authors.initials: O
authors.lastname: Ruffinengo
authors.forename: Silvina
authors.initials: S
authors.lastname: Benetti
authors.forename: Silvia E
authors.initials: SE
authors.lastname: García Borrás
authors.forename: M Celina
authors.initials: MC
authors.lastname: Rossi
authors.forename: Julio
authors.initials: J
authors.lastname: Vorobioff
authors.forename: Fernando
authors.initials: F
authors.lastname: Bessone
authors.forename: Hugo
authors.initials: H
authors.lastname: Tanno
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D001118:Argentina / Q000453:epidemiology; D058070:Asymptomatic Diseases; D001706:Biopsy; D001803:Blood Transfusion; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult