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Clinical outcomes of chronic hepatitis C patients related to baseline liver fibrosis stage: a hospital‐based linkage study
Author(s) -
Huang Y.,
Boer W. B.,
Adams L. A.,
MacQuillan G.,
Bulsara M. K.,
Jeffrey G. P.
Publication year - 2015
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12626
Subject(s) - medicine , hepatocellular carcinoma , decompensation , cirrhosis , gastroenterology , liver transplantation , hazard ratio , hepatitis c , population , liver biopsy , hepatitis , transplantation , biopsy , confidence interval , environmental health
Background and Aims Rates of long‐term clinical outcomes of chronic hepatitis C in patients with none, mild or severe liver fibrosis are required to determine benefits of anti‐viral therapies. This study evaluated long‐term outcomes for chronic hepatitis C stratified by all M etavir fibrosis stages. Methods Clinical outcomes were determined using population‐based data linkage methodology for 880 hepatitis C patients who had a liver biopsy performed from 1992 to 2012. Results During 9386 person‐years of follow up, 28 patients developed hepatocellular carcinoma, 58 developed liver decompensation and 122 died or underwent liver transplantation. There was no significant difference in liver‐related death for those with F 0– F 2 with an 18‐year survival probability >94%. Hazard ratio of liver‐related death for F 3 compared with F 0– F 2 was 4.24 ( P = 0.003), with no significant difference in the first 13‐year follow up. The 15‐year decompensation‐free survival for F 0, F 1 and F 2 was 100%, 96% and 94% respectively and for hepatocellular carcinoma‐free survival was 100%, 99% and 98%. Hazard ratio of liver complication (hepatocellular carcinoma or decompensation)‐free survival for F 3 compared with F 0– F 2 was 3.22 ( P = 0.001), with no significant difference during the first 7‐year follow up. F4 had significantly higher risk of liver‐related death, decompensation and hepatocellular carcinoma than F 3 ( P < 0.001). Conclusions Chronic hepatitis C patients with F 2 or less had few liver complications after 15 years. For F 3 patients, the significant increase in liver‐related death occurred after 13 years and for liver complications after 7 years.