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Severity of liver disease among chronic hepatitis C patients: An observational study of 4594 patients in five European countries
Author(s) -
Marcellin Patrick,
Grotzinger Kelly,
Theodore Dickens,
Demuth Dirk,
Manns Michael,
Bañares Cañizares Rafael,
Pike James,
Forssen Ulla M
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12698
Subject(s) - medicine , liver biopsy , fibrosis , hepatitis c virus , univariate analysis , hepatitis c , biopsy , liver disease , gastroenterology , multivariate analysis , immunology , virus
Background and Aim Assessment of the severity of liver disease following infection with hepatitis C virus ( HCV ) is important in treatment selection and prognosis. As invasive liver biopsy procedures are regarded as the reference method to assess the stage of fibrosis, it is important to identify patient characteristics that are predictive of liver fibrosis severity. The aim of the study was to describe the distribution of liver severity scores, clinical characteristics, and physicians' assessment of fibrosis among HCV patients in five E uropean countries. Methods This cross‐sectional study retrospectively reviewed the medical records of patients who were chronically infected with HCV in 2006. Patients managed for HCV at any of 60 sites in F rance, G ermany, I taly, S pain, and the UK were included. Data collected included patient demographics and clinical characteristics. A combination of univariate and multivariate regression analyses were used to identify predictors of fibrosis severity and factors associated with undergoing biopsy. Results Four thousand five hundred and ninety‐four chronically infected HCV patients were included in this analysis. Management approaches differed between countries, with variations in biopsy use (59.3–18.4%) and preferred fibrosis scoring systems. Where histology results were available, 43.4%, 23.8%, and 32.9% had mild, moderate, and severe fibrosis, respectively. Factors associated with undergoing a biopsy included male gender and co‐infection with hepatitis B virus. Chronic alcoholism, a lower first platelet count, and older age were predictors of increased liver fibrosis severity. Conclusions These data suggest that there are major differences in how specialists manage their HCV patients across five major E uropean countries.