Patient Age Predicts Fibrosis Progression

Advanced Age a Predictor of Fibrosis Progression in Hepatitis C
By Emma Patten

ATLANTA, Apr 14 (Reuters Health) - Liver fibrosis as a complication of hepatitis C virus (HCV) infection progresses in 33% of patients with chronic HCV, and the risk increases with age at infection, according to researchers who presented their findings at the 10th international symposium on Viral Hepatitis and Liver Disease here on Wednesday.

Dr. Marc G. Ghany, of the National Institute for Digestive and Kidney Diseases (NIDDK) and colleagues performed a retrospective study of 123 patients with chronic HCV infection who had at least two liver biopsies between 1981 and 1999. The mean age of the patients was 50 years and the majority were white males. The mean duration of HCV was 18 years and the mean duration between biopsies was 3.7 years.

The degree of fibrosis was categorized into four stages, ranging from no fibrosis to cirrhosis. Even though fibrosis progressed in 33% of the patients, 13% of the patients showed a decrease in fibrosis and 54% showed no change. Half of the patients who showed progression of fibrosis, however, developed a 2- or 3-point progression leading to the clinically important stages of either bridging fibrosis or cirrhosis.

Logistic regression was used to determine the contribution of a variety of factors to the progression of fibrosis. Fibrosis at initial biopsy was the strongest predictor of progression of fibrosis.

"We asked whether age played a role in the progression of fibrosis and found that the age at infection seemed to be very important. Patients who were infected at an older age seemed to develop fibrosis at a much more rapid rate," Dr. Ghany told Reuters Health.

"It probably has to do with stellate cell activity, and a more vigorous response to infection in these patients," he explained.

"These markers may be useful for monitoring disease progression and deciding whether to administer therapy. Patients who acquire infection at an older age may require more intensive therapy," he noted.

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