Most Chronic Hepatitis C Sufferers Will Develop Cirrhosis In Later Life

Hepatitis C is a virus that affects the liver and is spreadprimarily by contact with blood and blood products in transfusions andamong drug users who share needles. Other common routes of transmissionare infants born to HCV-infected mothers, tattoos and body piercingsand risky sexual behavior. Of those who are infected, more than 80percent will be chronic carriers of the disease. HCV can causelong-term scarring of the liver and usually presents with mild andnon-specific symptoms, if any. They include fatigue, nausea, poorappetite and muscle and joint pain. It is estimated that more than 4million Americans are now infected with HCV (more than 170 millionpeople worldwide) and nearly 10,000 Americans die from the disease eachyear.

"Hepatitis C begins generally as a silent acute infection, witha fraction of the patients developing cirrhosis, end-stage liverdisease or liver cancer," according to an editorial appearing in thismonth's journal. "Although this is a generally accepted scenario inpersons infected with HCV, there remains uncertainty about the truefrequency of evolution of liver disease and its rate of progression."

According to results of the study from researchers at the QueenMary's School of Medicine and Dentistry in London, the prevalence ofcirrhosis in patients with chronic HCV increases with the duration ofthe disease. Nearly 80 percent of Asian patients who were infected atbirth and lived with the disease for 60 years or more developedcirrhosis--a finding that researchers say can be applied to the generalpopulation because of the similarity in the way the disease progressesin all ethnic groups.

"This study suggests that prolonged infection with hepatitis Cleads to cirrhosis in the majority of those who are infected," saidGraham R. Foster, PhD, FRCP, study author and professor of hepatologyat Queen Mary's School of Medicine and Dentistry in London. "Whileprevious studies have found differences in disease progression invarious ethnic groups, our findings confirm that fibrosis progressionis the same across these groups and leads to development of cirrhosisand liver disease at the same rate in everyone."

Researchers conducted retrospective analyses of 382 patientsdiagnosed with hepatitis C at three hospitals in northeast Londonbetween 1992 and 2003. Study participants were divided into two groups:Asian patients presumably infected in childhood and Caucasian patients.While the prevalence of cirrhosis in Caucasian patients was similar tothe findings of previous studies, the statistics in Asians weremarkedly higher than previously found. The higher prevalence waspartially attributed to the longer duration of HCV in the Asian patientpopulation, those patients having suffered with the disease nearly 30years more than the Caucasian subjects.

This study was funded by local investigators and an unrestricted research grant from Roche Pharmaceuticals.

For more information on hepatitis C, visit www.gastro.org.

About the AGA
The American Gastroenterological Association (AGA) is dedicated to themission of advancing the science and practice of gastroenterology.Founded in 1897, the AGA is the oldest medical-specialty society in theUnited States. The AGA's 14,500 members include physicians andscientists who research, diagnose and treat disorders of thegastrointestinal tract and liver. On a monthly basis, the AGA publishestwo highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology.The AGA's annual meeting is Digestive Disease Week, which is held eachMay and is the largest international gathering of physicians,researchers and academics in the fields of gastroenterology,hepatology, endoscopy and gastrointestinal surgery.

About Clinical Gastroenterology and Hepatology
The mission of Clinical Gastroenterology and Hepatologyis to provide readers with a broad spectrum of themes in clinicalgastroenterology and hepatology. This monthly peer-reviewed journalincludes original articles as well as scholarly reviews, with the goalthat all articles published will be immediately relevant to thepractice of gastroenterology and hepatology. For more information,visit www.cghjournal.org.