Prognostic factors of unfavorable outcomes in patients with chronic hepatitis CDownload in PDF
To investigate the risk factors, prevalence and annual incidence of unfavorable outcomes in patients with chronic hepatitis C (CHC).
Material and methods
We conducted a retrospective study in 824 patients with CHC hospitalized between 2010 and 2016. Univariate and multivariate analysis was used to calculate odds ratios (ORs) for potential predictors of unfavorable outcomes.
The prevalence of liver cirrhosis (LC), decompensated LC, hepatocellular carcinoma (HCC), serious cryoglobulinemic vasculitis and B-cell lymphome in patients with CHC was 39.1%, 14.0%, 2.8%, 5.2%, and 1.2%, respectively. The prevalence of LC, decompensated LC, HCC adjusted for sex and age was 22.5%, 8.0%, and 1.5%, respectively. In patients with CHC, the annual rate of LC was 1.5% while in cirrhotic patients the annual rate of decompensated LC and HCC was 2.9% and 1.0%, respectively. In patients with CHC, the independent risk factors for LC included increased body mass index/obesity (OR 1.43), immunosuppressive therapy (OR 1.67), type 2 diabetes (OR 2.03), absence of antiviral therapy (OR 2.15), alcohol abuse (OR 2.34), duration of infection more than 20 years (ОR 2.74) and absence of sustained virological responce (SVR) (OR 2.98). The independent risk factors for decompensation in cirrhotic patients included type 2 diabetes (OR 1.47), alcohol abuse (OR 1.53), absence of antiviral therapy (OR 2.36) and SVR (OR 1.94). An episode of decompensation was the independent predictor for HCC in cirrhotic patients (OR 3.99).
Absence of antiviral therapy was one of the most important predictors for increased risk of LC, decompensation of LC, HCC and serious cryoglobulinemic vasculitis in patients with CHC. Prognostic scales for risk evaluation of LC, decompensation of LC and HCC were developed.
Chronic hepatitis C, liver cirrhosis, decompensation of cirrhosis, hepatocellular carcinoma, cryoglobulinemic vasculitis, B-cell lymphome, predictors, risk factors.