Rate of natural disease progression in patients with chronic hepatitis C

Researchers from France and the United States find that an interval of 4 to 5 years is needed between liver biopsies to measure change in patients with mild liver disease.

The interval at which liver biopsy should be repeated in untreated patients with chronic hepatitis C is not defined.

In this study, researchers examined fibrosis change by METAVIR scoring in patients who had 2 or more liver biopsies.

The team's findings are published in the March issue of the Journal of Hepatology.

The research team studied 180 patients with histologically proven chronic hepatitis C.

They found that the mean interval between biopsies was 3.67 years. This interval was 3.08 years in the 16 patients who had had 3 biopsies.

The team performed univariate and multivariate analyses to determine factors associated with liver fibrosis progression.

The mean interval between biopsies was 3.67 years.

They found that the median rate of fibrosis progression per year was 0.04 to first biopsy, 0 between first and second biopsy, and 0.17 between second and third biopsy.

Multivariate analysis determined that age at first biopsy >40 years (OR=5), and alcohol consumption of 1 to 50 g per day (OR=4), and more than 50 g per day (OR=8) were the only factors associated with severe fibrosis.

The team found that the number of patients who increased in fibrosis stage was significantly higher after 4 years.

Dr Jean-Pierre Zarski's team concluded, "An interval of at least 4 to 5 years is needed between liver biopsies to measure change in patients with mild liver disease."

J Hepatology 2003; 38(3): 307-14 21 February 2003