Hepatitis C virus enhances incidence of idiopathic pulmonary fibrosis

To investigate the cumulative development incidence and predictive factors for idiopathic pulmonary fibrosis in hepatitis C virus (HCV) positive patients.

We studied 6150 HCV infected patients who were between 40-70 years old (HCV-group). Another 2050 patients with hepatitis B virus (HBV) were selected as control (HBV-group). The mean observation period was 8.0 +/- 5.9 years in HCV-group and 6.3 +/- 5.5 years in HBV-group. The primary goal is the development ofidiopathic pulmonary fibrosis (IPF) in both groups. The cumulative appearance rate of IPF and independent factors associated with the incidence rate of IPF were calculated using the Kaplan-Meier method and the Cox proportional hazard model. All of the studies were performed retrospectively by collecting and analyzing data from the patient records in our hospital.

Fifteen patients in HCV-group developed IPF. On the other hand, none of the patients developed IPF in HBV-group. In HCV-group, the cumulative rates of IPF development were 0.3% at 10th year and 0.9% at 20th year. The IPF development rate in HCV-group was higher than that in HBV-group (P = 0.021). The IPF development rate in patients with HCV or HBV was high with statistical significance in the following cases: (1) patients > or = 55 years (P < 0.001); (2) patients who had smoking index (package per day multiply year) of > or = 20 (P = 0.002); (3) patients with liver cirrhosis (P = 0.042).

Our results indicate that age, smoking and liver cirrhosis enhance the development of IPF in HCV positive patients.