Document Detail


Acute exacerbations in chronic hepatitis C: a clinicopathological and prognostic study.
MedLine Citation:
PMID:  8773906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/METHODS: To examine the incidence, predisposing factors, clinicopathological characteristics and implications of acute exacerbations in chronic hepatitis C, a consecutive series of 194 biopsy-verified, anti-HCV-positive and hepatitis B surface antigen-negative patients were followed up and studied for the events of acute exacerbations, sustained biochemical resolution and development of cirrhosis. RESULTS: During a mean period of 6.2 +/- 3.5 (1.0-14.0) years, 151 episodes of acute exacerbations were recorded in 78 patients (40.2%). The estimated annual incidence of acute exacerbations was 11.9%. Fifty-five percent of acute exacerbations were asymptomatic. Histological study of acute exacerbations showed mild to moderate lobular inflammatory activities without bridging hepatic necrosis in all and periportal piecemeal in 23 (42.6%). The clinicopathological features of acute exacerbations in patients with chronic hepatitis C were less severe than those in patients with chronic hepatitis B. The route of infection, sex, age, mode of clinical presentation and the initial histology did not influence the occurrence of acute exacerbations. Only those with alanine aminotransferase > or = 300 U/l at entry tended to develop acute exacerbations more frequently (p < 0.001, odds ratio = 3.6, 95% confidence interval: 1.9-6.5). Acute exacerbations per se did not influence the subsequent development of cirrhosis or sustained biochemical resolution. Cirrhosis developed more frequently in patients with chronic active hepatitis at entry (p < 0.001, odds ratio = 6.5, 95% confidence interval: 2.6-16.0). Compared with baseline HCV-RNA level, HCV-RNA increased in 61% of acute exacerbations but the genotype remained unchanged in 75%. CONCLUSIONS: These results suggest that acute exacerbations also occur frequently in patients with chronic hepatitis C. They are clinically indolent, histologically less severe and not likely to be followed by sustained remission or development of cirrhosis.
Authors:
I S Sheen; Y F Liaw; D Y Lin; C M Chu
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hepatology     Volume:  24     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-11-22     Completed Date:  1996-11-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  525-31     Citation Subset:  IM    
Affiliation:
Liver Research Unit, Chang-Gung Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy
Causality
Chronic Disease
Female
Follow-Up Studies
Hepatitis B / complications,  epidemiology
Hepatitis B Surface Antigens / blood*
Hepatitis C / complications*,  epidemiology,  etiology,  pathology
Hepatitis C Antigens / blood*
Humans
Incidence
Liver Cirrhosis / etiology
Male
Middle Aged
Probability
Prognosis
Prospective Studies
Chemical
Reg. No./Substance:
0/Hepatitis B Surface Antigens; 0/Hepatitis C Antigens

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