Loading ...
Sorry, an error occurred while loading the content.

Diabetes, ALT >60, and weight can has effect on HCV progression

Expand Messages
  • claudine intexas
    NATAP - www.natap.org ---------------------------- AASLD Dallas, Nov 9-13 Reported by Jules Levin abstract 215. PREDICTIVE VARIABLES OF HCV-RELATED DISEASE
    Message 1 of 1 , Dec 5, 2001
    • 0 Attachment
      NATAP - www.natap.org ----------------------------

      AASLD
      Dallas, Nov 9-13
      Reported by Jules Levin

      abstract 215. PREDICTIVE VARIABLES OF HCV-RELATED
      DISEASE PROGRESSION: NEGATIVE EFFECT OF OVERWEIGHT:
      diabetes, ALT >60, and weight can has effect on HCV
      progression

      Vicente Ortiz M, Marina Berenguer F, Domingo Carrasco
      F, Miguel Rayon M, Joaquin Berenguer M, Hosp La FE,
      Valencia Spain

      Background: The natural history of chronic hepatitis C
      (CHC) is characterized by a wide variability, with
      progression to cirrosis in approximately 20% of
      patients within 20-30 years of infection.
      Identification of variables which may predict an
      agressive evolution is essential in order to improve
      patient management, particularly regarding therapy.
      The aim of this study was to assess the effect of
      several variables (biochemical, clinical, virological
      and immunological) in hepatitis C-related disease
      progression (fibrosis progression rate-FPR- > 0.2
      U/year).

      Methods: 114 chronic HCV-infected patients (anti-HCV
      and HCV-RNA positive) were evaluated prospectively
      between May 2000 and May 2001 (71 % genotype 1b).
      Fibrosis progression was defined by the annual change
      in the stage of fibrosis= difference between fibrosis
      stage in 2 consecutive biopsies divided by the time
      elapsed between these biopsies when they were
      available (n=17) or alternatively time between
      presumed infection (fibrosis 0) and the only biopsy
      available (n=97).Variables included as potential
      predictors of outcome included: age, sex, age at
      infection, history of alcohol intake of more than 5
      years (>40g/day in woman and >60g/day in men), risk
      factor of HCV acquisition (questionnaire), overweight
      (BMI=weight/height in m2), presence of autoantibodies,
      iron metabolism (ferritin, transferrin saturation),
      coexistent diabetes, hyperlipemia, markers of past HBV
      infection, genotype (Inno-Lipa) and viral load.

      Results: of the 114 patients, 22 (19.3%) were
      considered fast progressors (FPR>0.2U/year). Variables
      associated with progression by multivariate analysis
      are shown on table 1. The remaining variables were not
      predictive of disease progression.

      Conclusions: The presence of overweight (BMI=25), old
      age at infection, and high transaminase levels (>
      60IU/l) predict progression to cirrosis in less than
      20 years. These results suggest that therapeutical
      measures aimed at reducing the overweight may play a
      role in the management of HCV-infected patients,
      potentially leading to a slower progression of the
      disease.

      Editorial note: as you can see in the table below when
      ALT is >60 being overweight and having diabetes have a
      greater effect on HCV progression.

      TABLE ONE
      Patient Group: All Patients (n=114)
      Variable----------------------------P value
      Old Age ---------------------------- .0001
      BMI=/> 25* ------------------------- .013
      ALT Range** ------------------------ .016

      Patient Group: ALT =/< 60I/U (n=61)
      Variable----------------------------P value
      Old age at infection --------------- .002

      Patient Group: ALT > 60I/U (n=53)
      Variable----------------------------P value
      Old age at infection --------------- .0001
      BMI =/>25 -------------------------- .0001
      Transferrine saturation >45 -------- .003
      Diabetes --------------------------- .0001
      Unknown risk factor ---------------- .0001

      *BMI=/>25: 42 patients/14 fast progressors (33.3%);
      BMI <25: 72 patients/ 8 fast progressors (11.1%)
      ALT>60I/U: 53 patients/14 fast progresssors (26.4%);
      ALT 41-60I/U 30: patients/5 fast progressors (16.7%);
      ALT =/< 40I/U: 31 patients/3 fast progressors (9.7%)

      __________________________________________________
      Do You Yahoo!?
      Send your FREE holiday greetings online!
      http://greetings.yahoo.com
    Your message has been successfully submitted and would be delivered to recipients shortly.