title: Clinicobiochemical prediction of biopsy-proven cases of severe hepatic fibrosis in patients with chronic hepatitis C infection.
abstract: OBJECTIVE
  To evaluate clinicobiochemical factors predicting severe hepatic fibrosis in patients with chronic hepatitis C virus (HCV) infection.
  
  
  METHODS
  Tertiary institution.
  
  
  METHODS
  859 treatment-naïve Korean patients with HCV who underwent liver biopsy. Severe fibrosis was defined as fibrosis stage ≥3 based on the METAVIR system.
  
  
  METHODS
  Clinicobiochemical factors predicting severe hepatic fibrosis.
  
  
  RESULTS
  The median serum alanine aminotransferase (ALT) level was 68 IU/L and body mass index (BMI) was 24.2 kg/m(2). Severe fibrosis was observed in 326 (39.7%) of the 859 patients. The frequencies of severe fibrosis were 0%, 37.8%, 41.9% and 42% in patients with serum ALT concentrations (IU/L) of ≤20, 20-30, 30-40 and >40 (p<0.01), respectively, and 10.7%, 19.8%, 30.5%, 39.2% and 55.6% in patients <30, 30-40, 40-50, 50-60 and ≥60 years old, respectively (p<0.01). Categorised age in years (50-60 (OR 4.26, p=0.03) and ≥60 (OR 7.53, p<0.01) compared with <30), categorised ALT level in IU/L (20-30 (OR 16.76, p<0.01), 30-40 (OR 20.02, p<0.01) and >40 (OR 21.49, p<0.01) compared with ≤20) and BMI >27.5 kg/m(2) (OR 1.65, p=0.03) were independently related to severe fibrosis in patients with chronic HCV. The severe fibrosis rate was 60.6% in patients aged ≥50 years with ALT >20 IU/L and BMI >27.5 kg/m(2).
  
  
  CONCLUSIONS
  More advanced age (≥50 years), obesity and serum ALT>20 IU/L are associated with severe fibrosis in patients with chronic HCV. Anti-HCV therapy may be considered for these patients without histological confirmation, regardless of HCV genotype. A wait-and-see policy may be justified for patients with serum ALT ≤20 IU/L.
authors.affiliation: Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Jin
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Liver Center, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Shim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Liver Center, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Gi Ae
authors.initials: GA
authors.lastname: Kim
authors.affiliation: Department of Pathology, University of Ulsan College of Medicine, Asan Liver Center, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Liver Center, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Kang Mo
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Liver Center, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Young-Suk
authors.initials: YS
authors.lastname: Lim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Liver Center, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Han Chu
authors.initials: HC
authors.lastname: Lee
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001706:Biopsy; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000453:epidemiology*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000410:Alanine Transaminase