Genotype 3 is associated with accelerated fibrosis progression in chronic hepatitis C

Bochud, Pierre-Yves; Cai, Tao; Overbeck, Kathrin; Bochud, Murielle; Dufour, Jean-François; Müllhaupt, Beat; Borovicka, Jan; Heim, Markus; Moradpour, Darius; Cerny, Andreas; Malinverni, Raffaele; Francioli, Patrick; Negro, Francesco (2009). Genotype 3 is associated with accelerated fibrosis progression in chronic hepatitis C. Journal of hepatology, 51(4), pp. 655-66. Amsterdam: Elsevier 10.1016/j.jhep.2009.05.016

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BACKGROUND/AIMS: While several risk factors for the histological progression of chronic hepatitis C have been identified, the contribution of HCV genotypes to liver fibrosis evolution remains controversial. The aim of this study was to assess independent predictors for fibrosis progression. METHODS: We identified 1189 patients from the Swiss Hepatitis C Cohort database with at least one biopsy prior to antiviral treatment and assessable date of infection. Stage-constant fibrosis progression rate was assessed using the ratio of fibrosis Metavir score to duration of infection. Stage-specific fibrosis progression rates were obtained using a Markov model. Risk factors were assessed by univariate and multivariate regression models. RESULTS: Independent risk factors for accelerated stage-constant fibrosis progression (>0.083 fibrosis units/year) included male sex (OR=1.60, [95% CI 1.21-2.12], P<0.001), age at infection (OR=1.08, [1.06-1.09], P<0.001), histological activity (OR=2.03, [1.54-2.68], P<0.001) and genotype 3 (OR=1.89, [1.37-2.61], P<0.001). Slower progression rates were observed in patients infected by blood transfusion (P=0.02) and invasive procedures or needle stick (P=0.03), compared to those infected by intravenous drug use. Maximum likelihood estimates (95% CI) of stage-specific progression rates (fibrosis units/year) for genotype 3 versus the other genotypes were: F0-->F1: 0.126 (0.106-0.145) versus 0.091 (0.083-0.100), F1-->F2: 0.099 (0.080-0.117) versus 0.065 (0.058-0.073), F2-->F3: 0.077 (0.058-0.096) versus 0.068 (0.057-0.080) and F3-->F4: 0.171 (0.106-0.236) versus 0.112 (0.083-0.142, overall P<0.001). CONCLUSIONS: This study shows a significant association of genotype 3 with accelerated fibrosis using both stage-constant and stage-specific estimates of fibrosis progression rates. This observation may have important consequences for the management of patients infected with this genotype.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute of Clinical Pharmacology and Visceral Research (discontinued)

UniBE Contributor:

Dufour, Jean-François

ISSN:

0168-8278

ISBN:

19665246

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:07

Last Modified:

04 May 2014 23:21

Publisher DOI:

10.1016/j.jhep.2009.05.016

PubMed ID:

19665246

Web of Science ID:

000270749000012

URI:

https://boris.unibe.ch/id/eprint/29609 (FactScience: 153938)

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