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Changes in hepatitis C-related liver disease in a large clinic population
G Ostapowicz1, M Dallinger, S J Bell
1Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
Insights
Hepatitis C virus (HCV) infection is a growing concern in Australia. This study analyzed 1,546 patients, finding increased general practitioner referrals and identifying patient age as a key predictor of cirrhosis.
Area of Science:
- Hepatology
- Infectious Diseases
- Epidemiology
Background:
- Hepatitis C virus (HCV) infection presents a significant public health challenge in Australia.
- Diagnosed cases of hepatitis C have seen a notable increase in recent years.
- Previous analysis of 342 patients was conducted in 1994.
Purpose of the Study:
- To characterize the clinical profile of a large cohort of chronic HCV patients.
- To investigate shifts in referral patterns and epidemiological features.
- To update understanding of HCV patient demographics and clinical outcomes.
Main Methods:
- Retrospective analysis of 1,546 anti-HCV-positive patients referred between January 1990 and June 1998.
- Collection of comprehensive clinical and laboratory data for all included patients.
- Examination of referral sources, risk factors, and prevalence of cirrhosis.
Main Results:
- General practitioner referrals rose from 31% to 70% between 1990-1993 and 1994-1998.
- Injecting drug use (IDU) was identified as a risk factor in 64% of patients.
- Cirrhosis was diagnosed in 18% of biopsied patients, with patient age being the sole independent predictor.
Conclusions:
- Most Hepatitis C virus patients are diagnosed within general practice settings.
- A specific risk factor for HCV infection is identified in the majority of cases (82%).
- While cirrhosis prevalence may be overestimated, the overall disease burden of HCV is substantial.
Background:
Hepatitis C virus (HCV) infection is a significant problem in the Australian community. Over the past few years, the number of patients with diagnosed hepatitis C has increased greatly. The aims of the present study were to define the clinical features of a large group of patients with chronic HCV infection and to examine changes occurring in the referral base and epidemiological characteristics of this group since analysis of the first 342 patients in 1994.
Methods:
The study included 1,546 consecutive anti-HCV-positive patients who had been referred to St Vincent's Hospital from January 1990 to June 1998. Clinical and laboratory data were collected on all patients.
Results:
Referrals from general practitioners increased from 31% to 70% of all patients between 1990-1993 and 1994-1998. A history of injecting drug use (IDU) was present in 64% of the patients. While 89% of the IDU group was Australasian born, 49% of those in the sporadic group were born overseas. Cirrhosis was found in 18% of biopsied patients. Age, infection duration, age at infection, Mediterranean or Asian origin and a history of transfusion or lack of HCV risk factors were associated with cirrhosis on univariate analysis. Patient age was the only independent predictor of cirrhosis.
Conclusion:
The majority of patients with HCV are diagnosed in general practice. A risk factor for infection is identified in 82% of patients. While our reported prevalence of cirrhosis may be an overestimate of that in the overall HCV community, the ultimate disease burden is likely to be significant.