Factors Associated With Hepatic Fibrosis In Patients With Chronic Hepatitis C A Retrospective Study of a Large Cohort of U.S. Patients

Goals: To determine the risk factors for stage 3 and 4 fibrosis in a large cohort of U.S. patients with chronic hepatitis C: (CHC). Background: Multiple host and viral factors affect the outcomes of CHC. Further defining the pathogenic roles of these factors in CHC progression will lead to improving management of this disease. Study: Retrospective study of a large cohort of US patients with CHC. Results: Of the 460 patients. 331 were males and 129 were females with mean age of 48.4 +/- 8.0 years, and 191 (41.7%) had stage 3 and 4 fibrosis. Clinically, a multivariate analysis revealed that age of >= 60 years at presentation. the estimated duration of hepatitis C Virus (HCV) infection >= 25 years, a body mass index >= 30 kg/m(2), and a history of diabetes mellitus were independently associated with stage 3 and 4 fibrosis, after adjusting for history of alcohol use. Laboratorially, a multivariate analysis revealed that aspartate aminotransferase (AST) >= 2 x upper limit of normal (ULN). alpha fetoprotein >= 15 mu g/L, and presence of grade 2 and 3 steatosis were independently associated with stage 3 and 4 fibrosis. after adjusting for alanine aminotransferase >= 2 x upper limit of normal, AST/alanine aminotransferase ratio >= 1. HCV genotyping. transferrin saturation. and a histology activity index score >= 7. Conclusions: The present study indicated that elderly. longer duration of HCV infection. obesity. :and history of diabetes mellitus are independent clinical parameters associated with advanced fibrosis, whereas elevated AST, alpha fetoprotein. and presence of grade 2 and 3 steatosis are independent laboratorial parameters associated with stage 3 and 4 fibrosis in patients with CHC.