Chronic hepatitis C infection. With special reference to prevalence, aggravating factors and longterm outcome

Abstract: Since the discovery of hepatitis C virus (HCV) in 1989, it has proved to be a formidable health problem with a major impact on morbidity and mortality throughout the world. In this investigation, patients with chronic hepatitis C infection have been studied with special reference to prevalence, aggravating factors and longterm outcome. The prevalence of HCV infection was high (approximately 10 %) among patients assessed because of chronic liver disease. Although most patients were asymptomatic at entry, the majority of liver biopsied patients with HCV infection manifested histological changes such as CPH, CAH and cirrhosis. A parenteral route of HCV transmission was established in the majority of anti­HCV positive patients, and the frequency of community acquired chronic hepatitis C was low. Non-invasive assessment to predict histological grade and stage appears to be of limited value. Individual test results were characterized by considerable overlap between the histological groups, and PIIIP, CL­IV and IgG seem to be nonspecific correlates of histological activity. The rate of development of severe liver disease among HCV positive patients appears to be dependent both on endogenous and exogenous factors. Alcohol abuse and ACT deficiency were both independent risk factors for the development of cirrhosis. A high proportion of HCV infected individuals are at serious longterm risk of severe or fatal illness. During a median followup time of 10 years, more than 60 % of the deceased HCV positive patients developed cirrhosis, and approximately 30 % had concomitant HCC.