Outcome of liver disease in a large cohort of histologically proven chronic hepatitis C: influence of HCV genotype

Roffi, Luigi; Redaelli, A.; Colloredo, Guido; Minola, E.; Donada, Carlo; Picciotto, Antonino; Riboli, Paolo; Poggio, P. Del; Rinaldi, G.; Paris, Bruno; Fornaciari, Giovanni; Giusti, Massimo; Marin, R.; Morales, Rino; Sangiovanni, A.; Belloni, G; Pozzi, Massimo; Poli, Giancarla; Mascoli, Nerina; Corradi, Chiara; Pioltelli, Pietro; Scalori, Astrid; Mancia, Giuseppe

doi:10.1097/00042737-200105000-00007

Cited by 31 publications

(26 citation statements)

References 36 publications

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“…It has been suggested that genotype may influence progression of chronic liver disease. Some studies have indicated that HCV genotype 1 is associated with more aggressive liver disease (6,7), but this has not been a consistent finding. In addition to clinical differences, the various genotypes have distinct geographical distributions.…”

Section: Introductionmentioning

confidence: 95%

Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study

Carmo

Oliveira

Guimarães

et al. 2002

Braz J Med Biol Res

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We determined and analyzed risk factors of hepatitis C virus (HCV)-infected Brazilian hemophiliacs according to their virological, clinical and epidemiological characteristics. A cross-sectional and retrospective study of 469 hemophiliacs was carried out at a Brazilian blood center starting in October 1997. The prevalence of HCV infection, HCV genotypes and factors associated with HCV RNA detection was determined. The seroprevalence of anti-HCV antibodies (ELISA-3.0) was 44.6% (209/469). Virological, clinical and epidemiological assessments were completed for 162 positive patients. There were seven (4.3%) anti-HCV seroconversions between October 1992 and October 1997. During the same period, 40.8% of the positive anti-HCV hemophiliacs had abnormal alanine transaminase (ALT) levels. Plasma HCV RNA was detected by nested-RT-PCR in 116 patients (71.6%). RFLP analysis showed the following genotype distribution: HCV-1 in 98 hemophiliacs (84.5%), HCV-3 in ten (8.6%), HCV-4 in three (2.6%), HCV-2 in one (0.9%), and not typeable in four cases (3.4%). Univariate analysis indicated that older age (P = 0.017) and abnormal ALT levels (P = 0.010) were associated with HCV viremia, while the presence of inhibitor antibodies (P = 0.024) and HBsAg (P = 0.007) represented a protective factor against the presence of HCV RNA. These findings may contribute to a better understanding of the relationship between HCV infection and hemophilia.

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Section: Introductionmentioning

confidence: 95%

Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study

Carmo

Oliveira

Guimarães

et al. 2002

Braz J Med Biol Res

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“…The knowledge of genotypes in chronic hepatitis C seems also crucial to identify those patients who need more aggressive therapeutic management. In fact, genotypes 1 and 4 show more resistance as compared to genotypes 2 and 3 to pegylated-interferon (PEG-IFN) and ribavirin combination therapy and thus require different treatment duration and dose [9,10,11,12]. …”

Section: Introductionmentioning

confidence: 99%

Distribution Pattern of Hepatitis C Virus Genotypes and Correlation with Viral Load and Risk Factors in Chronic Positive Patients

et al. 2014

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Objective: Hepatitis C virus (HCV) has emerged as a leading cause of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma worldwide. The purpose of this study was to describe the distribution pattern of HCV genotypes in chronic hepatitis patients in the Campania region of southern Italy and estimate their association with risk factors and viral load. Materials and Methods: 404 consecutive HCV ribonucleic acid-positive patients were included in the study. HCV genotyping was carried out by the HCV line probe assay test and viral load estimation by the TaqMan real-time PCR system. Results: The predominant genotype was 1 (63.6%), followed by genotype 2 (29.4%), 3 (6.2%) and 4 (0.8%). Subtype 1b was more frequent in females than in males. Conversely, genotype 3 was more frequent in males. No significant difference was observed in age distribution of HCV genotypes. Surgery and dental therapy were the most frequent risk factors for genotype 1 and intravenous drug abuse and tattooing for genotype 3. Patients with genotype 1 more frequently showed high HCV viral load when compared to those with genotypes 2 and 3. Conclusion: The present study revealed that HCV genotypes 1 and 2 accounted for over 95% of all HCV infections in the Campania region, and genotype 1 was more frequently associated with a higher viral load when compared to genotypes 2 and 3.

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“…Although IFN therapy for chronic hepatitis C, both with standard and pegylated drugs, is commonly thought to prevent or delay HCC 5, [7][8][9]13 , in the present case severity of disease unexpectedly increased during treatment and concomitantly with viral clearance. On the grounds of its local diffuseness, the tumor was seemingly pre-existing, however neither laboratory tests nor ultrasound investigation had diagnosed it previously, and despite unhomogeneous liver echotexture with hypo-and hyperechoic scattered areas, nevertheless focal lesions were not identifiable.…”

Section: Discussionmentioning

confidence: 64%

“…Specifically, HCV-related liver cirrhosis accounts for about 4% risk per year of developing HCC [5][6] , and the tumor incidence in North America, Europe and Japan is increasing, mainly as a consequence of HCV diffusion during the previous decades 1 . Although the mechanisms by which the virus promotes hepatocarcinogenesis are not completely clear yet, interferon (IFN) therapy seems of benefit in preventing HCC, owing to antimitogenic and antioxidative properties, both in sustained virological responders and in transient biochemical responders [7][8][9] . Since tumor diffusion significantly limits an effective removal of lesions 4 , procedures for disclosing primary nodules in cirrhotics have been carefully standardized by major scientific societies 10 .…”

Section: Introductionmentioning

confidence: 99%

Occurrence of Diffuse, Poorly Differentiated Hepatocellular Carcinoma During Pegylated Interferon Plus Ribavirin Combination Therapy for Chronic Hepatitis C

Capanni

Lorefice²,

Benini³

et al. 2008

Journal of Chemotherapy

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SummaryInterferon therapy is indicated for the treatment of chronic hepatitis C and prevention of hepatocellular carcinoma. We describe the case of a 66-year-old Italian woman who received pegylated interferon α α-2a plus ribavirin combined therapy for HCV-related chronic liver disease. Preliminary hematochemical, ultrasound and bioptic investigations did not show liver cirrhosis or hepatocarcinoma. After 24 weeks of treatment transaminase serum levels were in the normal range and circulating HCV-RNA was undetectable by PCR qualitative assay. On week 46 a serious adverse event occurred, with rapid transaminase increase, severe hyperpyrexia, and abdominal pain, leading to interruption of interferon and ribavirin. Liver biopsy was repeated and it revealed poorly differentiated hepatocellular carcinoma. Only palliative care could be performed and the patient died of liver failure within 2 months. The present case underlines that hepatocellular carcinoma can be misdiagnosed in spite of laboratory and instrumental follow-up. More sensitive tools are needed for tumor detection, to avoid IFN impairment of the liver, even though it eradicates HCV.

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Outcome of liver disease in a large cohort of histologically proven chronic hepatitis C: influence of HCV genotype

Cited by 31 publications

References 36 publications

Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study

Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study

Distribution Pattern of Hepatitis C Virus Genotypes and Correlation with Viral Load and Risk Factors in Chronic Positive Patients

Occurrence of Diffuse, Poorly Differentiated Hepatocellular Carcinoma During Pegylated Interferon Plus Ribavirin Combination Therapy for Chronic Hepatitis C

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