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Risk factors of unfavorable prognosis of chronic hepatitis C

S E Shchanitcyna1, E Z Burnevich1,2, E N Nikulkina1

  • 1I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.

Terapevticheskii Arkhiv
|May 17, 2019
PubMed

Insights

Identifying risk factors for chronic hepatitis C (CHC) complications like liver cirrhosis (LC) and liver cancer (HCC) is crucial. Key predictors include diabetes, alcohol abuse, and lack of antiviral therapy or sustained virological response (SVR).

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Oncology

Background:

  • Chronic hepatitis C (CHC) poses significant risks for severe liver disease and extrahepatic manifestations.
  • Understanding predictors of unfavorable prognosis is essential for patient management and preventative strategies.

Purpose of the Study:

  • To identify risk factors for unfavorable outcomes in CHC patients, including liver cirrhosis (LC), decompensated LC, hepatocellular carcinoma (HCC), cryoglobulinemic vasculitis (CryoVas), and B-cell non-Hodgkin's lymphoma.

Main Methods:

  • Retrospective study of 824 CHC patients (2010-2016).
  • Multivariate logistic regression analysis was employed to determine odds ratios (ORs) for risk factors and predictors of adverse outcomes.

Main Results:

  • Identified risk factors for LC: elevated BMI, immunosuppressive therapy, diabetes type 2, absence of antiviral therapy, alcohol abuse, prolonged infection duration (≥20 years), and absence of SVR.
  • Risk factors for decompensated LC included diabetes type 2, alcohol abuse, absence of antiviral therapy, and absence of SVR.
  • Decompensation episodes predicted HCC (OR 3.99). Genotype 1b and absence of antiviral therapy were associated with serious CryoVas.

Conclusions:

  • Several factors are independently associated with increased risk for LC, decompensation, HCC, and serious CryoVas in CHC patients.
  • The study quantifies the incidence of unfavorable outcomes in CHC, including rare extrahepatic manifestations.
Abstract

Keywords:
B-cell lymphomechronic hepatitis Ccryoglobulinemic vasculitisdecompensation of cirrhosishepatocellular carcinomaliver cirrhosispredictorsrisk factors

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