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Lack of correlation between of HCV genotypes & clinical
course of Hepatitis C related cirrhosis
The influence of the hepatitis C virus (HCV)-genotype on liver
disease severity was evaluated in 429 consecutive patients with
chronic hepatitis C, including 109 with cirrhosis who were followed
up prospectively, allowing for the assessment of the role of the
HCV -genotype on disease outcome and on the development of
hepatocellular carcinoma (HCC). HCV-1 was detected in 147 (46%)
patients without cirrhosis and in 47 (43%) with cirrhosis (P: not
significant), being mainly HCV-1b. HCV-2 was found in 103 (32%)
cases without cirrhosis and in 30 (27.5) with cirrhosis (P: not
significant), being mainly HCV-2a. HCV-3 was detected in 32 (10%)
patients without cirrhosis and in 2 (2%) with cirrhosis (P <
0.005). Infection with more than one genotype (HCV-1/HCV-2 and
HCV-1/HCV-3) was observed only in cirrhotic patients (6 of 109;
5.5%). During a mean follow-up of 67 +/- 22 months, 21 (19%)
patients with cirrhosis showed worsening in Child's stage, 5 (4.5%)
underwent liver transplantation, 23 (21%) developed HCC, and 24
(22%) died of complication of Liver disease; the overall incidence
of at least one of these events was 38.5%. By the Kaplan-Meier
method and log-rank test, the cumulative probability of developing
each or at least one of the above events did not differ in relation
to the genotype of infecting HCV, apart from patients with mixed
genotype infection who showed a significantly higher incidence of
death (P <.05). These data indicate that HCV-genotypes do not
have a significant effect on the severity and outcome of liver
disease in patients with chronic HCV-infection. Patients with
cirrhosis who are also infected by HCV- 1 and HCV-2 had a similar
prognosis and progression to HCC, while patients infected by more
than one genotype showed the most unfavorable course of
disease.
Author: A ALBERTI, UNIV PADUA, MED CLIN 2, VIA GIUSTINIANI 2,
I-35128 PADUA, ITALY
Source: HEPATOLOGY 1997 JAN;25(1):211-215
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