Clinicobiochemical prediction of biopsy-proven cases of severe hepatic fibrosis in patients with chronic hepatitis C infection.

ABSTRACT: To evaluate clinicobiochemical factors predicting severe hepatic fibrosis in patients with chronic hepatitis C virus (HCV) infection.Tertiary institution.859 treatment-naïve Korean patients with HCV who underwent liver biopsy. Severe fibrosis was defined as fibrosis stage ?3 based on the METAVIR system.Clinicobiochemical factors predicting severe hepatic fibrosis.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).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.

SUBMITTER: Jin YJ 

PROVIDER: S-EPMC4248083 | biostudies-other | 2014

REPOSITORIES: biostudies-other