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Long-term follow-up of chronic hepatitis C in Japan
Hiroshi Okano1, Katsuya Shiraki, Hidekazu Inoue
1First Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
Insights
Chronic hepatitis C progresses to liver cirrhosis and hepatocellular carcinoma, especially in chronic active hepatitis 2A and 2B. Close monitoring of these patients is crucial for early detection and management.
Area of Science:
- Hepatology
- Viral Hepatitis Research
- Gastroenterology
Background:
- Chronic hepatitis C is a significant global health concern with a variable disease course.
- Understanding the natural history of chronic hepatitis C is essential for effective patient management.
Purpose of the Study:
- To investigate the long-term outcomes of different stages of chronic hepatitis C.
- To assess the progression rates to liver cirrhosis and hepatocellular carcinoma.
Main Methods:
- A cohort of 161 patients with chronic hepatitis C underwent repeated liver biopsies.
- Patients were classified into chronic persistent hepatitis, chronic active hepatitis 2A, and chronic active hepatitis 2B groups.
Main Results:
- All stages showed progression to liver cirrhosis, with higher rates in chronic active hepatitis 2A and 2B compared to chronic persistent hepatitis.
- Hepatocellular carcinoma was observed in chronic active hepatitis 2A and 2B, often associated with liver cirrhosis.
- No hepatocellular carcinoma developed in the chronic persistent hepatitis group during the study period.
Conclusions:
- Patients with chronic active hepatitis 2A or 2B, particularly those with ongoing inflammation, require vigilant follow-up.
- Early detection and intervention are critical for managing chronic hepatitis C progression.
Background/Aims:
Chronic hepatitis C which exhibits a varied natural course, is becoming a major problem worldwide.
Methodology:
In this study, we investigated 161 patients with chronic hepatitis C by repeated liver biopsies. From initial biopsies, we diagnosed 56 patients with chronic persistent hepatitis, 74 with chronic active hepatitis 2A, and 31 with chronic active hepatitis 2B.
Results:
During the follow-up period, a progression from chronic hepatitis to liver cirrhosis was recognized among all stages, however the rate of progression to liver cirrhosis was less in chronic persistent hepatitis than in chronic active hepatitis 2A and chronic active hepatitis 2B. Hepatocellular carcinoma was detected in chronic active hepatitis 2A and chronic active hepatitis 2B at the initial stage, however, no tumors developed in chronic persistent hepatitis at the initial stage. Most hepatocellular carcinomas were concomitant with liver cirrhosis.
Conclusions:
We suggest a close follow-up of patients with chronic hepatitis C, especially those patients with chronic active hepatitis 2A or 2B and exhibiting successive active inflammation of liver.