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

Bochud, Pierre-Yves and Cai, Tao and Overbeck, Kathrin and Bochud, Murielle and Dufour, Jean-François and Müllhaupt, Beat and Borovicka, Jan and Heim, Markus and Moradpour, Darius and Cerny, Andreas and Malinverni, Raffaele and Francioli, Patrick and Negro, Francesco. (2009) Genotype 3 is associated with accelerated fibrosis progression in chronic hepatitis C. Journal of hepatology : journal of the European Association for the Study of the Liver, Vol. 51. pp. 655-666.

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Official URL: http://edoc.unibas.ch/dok/A6005277

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Abstract

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.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Department of Biomedicine, University Hospital Basel > Hepatology Laboratory (Heim)
UniBasel Contributors:Heim, Markus H.
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Elsevier
ISSN:0168-8278
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Mar 2013 11:13
Deposited On:01 Mar 2013 11:08

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