Prognostic factors for progression of liver structural lesions in chronic hepatitis C patients

Table 1 Clinical and laboratory features of patients at first biopsy

Variables	Values
Number of patients	112
Age in years (mean ± SD)	46.9 ± 12.3
Gender (Male/Female)	65/47 (58%/42%)
Age at infection in years (mean ± SD)	25.8 ± 13.1
Route of infection
Blood transfusion	52/112 (46.4%)
Illegal drug use	13/112 (11.6%)
Other known routes	28/112 (25.0%)
Unknown	19/112 (17.0%)
Duration of infection in years (mean ± SD)	22.7 ± 10.8
Laboratory
Alanine aminotransferase (× UNL)	2.96 ± 2.43
Aspartate aminotransferase (× UNL)	1.74 ± 1.16
Gamma-glutamyltranspeptidase (× UNL)	1.28 ± 0.97
Serum albumin (mg/dL)	4.32 ± 0.51
Prothrombin activity (%)	90.2 ± 9.9
Platelet count (/mm3)	216 510 ± 68 088
Genotyping of HCV
1	73/105 (69.5%)
Non-1	31/105 (29.5%)
Indeterminate	1/105 (0.9%)
Liver Histopathology
Lymphoid aggregates	54/112 (48.2%)
Ductal injury	13/112 (11.6%)
Steatosis	58/112 (51.8%)
Siderosis	20/112 (18.0%)
IFN Receptors	79/110 (71.8%)
Fibrosis (METAVIR scoring system)
F0	19/112 (17.0%)
F1	41/112 (36.6%)
F2	25/112 (22.3%)
F3	6/112 (5.4%)
F4	21/112 (18.8%)
Histological Activity (METAVIR scoring system)
A0	27/112 (24.1%)
A1	53/112 (47.3%)
A2	24/112 (21.4%)
A3	8/112 (7.1%)
Treatment
Non-treated	33/112 (29.5%)
Treatment responders	23/112 (20.5%)
Treatment non-responders	56/112 (50.0%)

UNL: Upper normal limit.

Table 2 Univariate analysis of factors associated with presence of significant hepatic disease according to liver biopsy in patients with chronic HCV infection

Variables	Odds ratio	95% CI	P
Age at first biopsy (yr)	1.0853	1.0370-1.1357	0.001
Duration of infection	1.0593	1.0198-1.1004	0.003
Gender	1.2719	0.5553-2.9132	0.569
Illegal drug use	0.6639	0.2241-1.9666	0.460
Blood transfusion	0.5792	0.2525-1.3284	0.197
ALT	1.2000	0.9808-1.4682	0.076
AST	1.4133	0.9681-2.0633	0.073
GGT	1.2978	0.8178-2.0594	0.268
Albumin	0.3660	0.1556-0.8604	0.021
Prothrombin activity	0.9252	0.8797-0.9730	0.003
Platelets	0.9999	0.9999-1.0000	0.107
Steatosis	1.8571	0.8110-4.2525	0.143
Lymphoid aggregates	3.9747	1.6612-9.5081	0.002
Ductal injury	1.9523	0.4574-8.3329	0.366
Siderosis	9.5454	2.0376-44.7150	0.004
IFN receptors	0.4285	0.1679-1.0938	0.076
Infection duration	0.9975	0.9606-1.0358	0.898

Table 3 Logistic regression analysis to identify most appropriate models for predicting progression of disease

Activity or fibrosis (A≥2 and/or F≥2)			95% CI
Variables	Odds ratio	P	Lower	Upper
Age at first biopsy (yr)	1.1045	0.001	1.0463	1.1659
ALT	1.3333	0.021	1.0450	1.7011
Lymphoid aggregates	4.8340	0.005	1.6118	14.4979
Siderosis	6.4875	0.032	1.1748	35.8233

Table 4 METAVIR indirect progression of fibrosis in patients with chronic hepatitis C according to histologic severity

	Liver fibrosis progression (fibrosis units/yr)
	n	mean ± SD
Mild disease	45	0.0356 ± 0.0552
Severe disease	48	0.1733 ± 0.1424
Total	93	0.1067 ± 0.1289

Student’s t, P < 0.0001.

Table 5 METAVIR direct progression of structural disturbances in patients with chronic hepatitis C

		Direct fibrosis progression (fibrosis units/yr)
Treatment	n	Mean	SD	Median	25%-75%
Non-treated	33/112 (29.4%)	0.2184	0.4982	0	0.000-0.500
Non-responders	56/79 (70.9%)	0.0382	0.3661	0	0.000-0.000
Responders	23/79 (29.1%)	-0.1459	0.4584	0	-0.461-0.000

P = 0.0117; Kruskal-Wallis; Non-treated vs treated, P = 0.0270; Non-responders vs Responders, P = 0.0344; Non-treated vs responders, P = 0.0053; Non-treated vs non-responders, P = 0.1413. Mann-Whitney/Wilcoxon.