Fibrosis in patients with chronic hepatitis C: Detection and significance

被引:116
作者
Poynard, T
Ratziu, V
Benmanov, Y
Di Martino, V
Bedossa, P
Opolon, P
机构
[1] Grp Hosp Pitie Salpetriere, Serv Hepatogastroenterol, F-75651 Paris 13, France
[2] Hop Bicetre, Serv Anat Pathol, Paris, France
关键词
fibrosis; HCV; ribavirin; liver biopsy;
D O I
10.1055/s-2000-9258
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Estimates of the extent of hepatic fibrosis and the rate of fibrosis progression represent important surrogate end points for evaluation of the vulnerability of an individual patient and for assessment of the impact of treatment on natural history in chronic hepatitis C. Using the median fibrosis progression rate, the median expected time to cirrhosis in untreated patients is around 30 years. However one third of patients have an expected median time to cirrhosis of less than 20 years and one third will only progress to cirrhosis in more than 50 years, if ever. Factors independently associated with fibrosis progression are duration of infection, age, male gender; consumption of alcohol human immunodeficiency virus co-infection, and low CD4 count, Evaluation of fibrosis progression is useful to decide treatment. Among patients with sustained viral response, fibrosis regresses. Evaluation of fibrosis progression has permitted validation of the concept of suppressive therapy. Among patients without viral clearance, interferon alone or in combination wish ribavirin significantly reduces fibrosis progression rate in comparison with progression before treatment and to control groups. There is a major need for noninvasive markers of liver fibrosis, None are clearly useful today for the diagnosis of early stages of fibrosis.
引用
收藏
页码:47 / 55
页数:9
相关论文
共 68 条
[21]  
HUARD P, 1935, ANN ANAT PATHOL, V12, P1118
[22]   OUTCOME OF PATIENTS HOSPITALIZED FOR COMPLICATIONS AFTER OUTPATIENT LIVER-BIOPSY [J].
JANES, CH ;
LINDOR, KD .
ANNALS OF INTERNAL MEDICINE, 1993, 118 (02) :96-98
[23]   Increased levels of soluble adhesion molecules in the serum of patients with hepatitis C - Correlation with cytokine concentrations and liver inflammation and fibrosis [J].
Kaplanski, G ;
Farnarier, C ;
Payan, MJ ;
Bongrand, P ;
Durand, JM .
DIGESTIVE DISEASES AND SCIENCES, 1997, 42 (11) :2277-2284
[24]   Circulating matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-1 as serum markers of fibrosis in patients with chronic hepatitis C - Relationship to interferon response [J].
Kasahara, A ;
Hayashi, N ;
Mochizuki, K ;
Oshita, M ;
Katayama, K ;
Kato, M ;
Masuzawa, M ;
Yoshihara, H ;
Naito, M ;
Miyamoto, T ;
Inoue, A ;
Asai, A ;
Hijioka, T ;
Fusamoto, H ;
Kamada, T .
JOURNAL OF HEPATOLOGY, 1997, 26 (03) :574-583
[25]   FORMULATION AND APPLICATION OF A NUMERICAL SCORING SYSTEM FOR ASSESSING HISTOLOGICAL ACTIVITY IN ASYMPTOMATIC CHRONIC ACTIVE HEPATITIS [J].
KNODELL, RG ;
ISHAK, KG ;
BLACK, WC ;
CHEN, TS ;
CRAIG, R ;
KAPLOWITZ, N ;
KIERNAN, TW ;
WOLLMAN, J .
HEPATOLOGY, 1981, 1 (05) :431-435
[26]  
LEBREC D, 1982, GASTROENTEROLOGY, V83, P338
[27]  
Lindor KD, 1996, HEPATOLOGY, V23, P1079
[28]   THE NOMENCLATURE OF CHRONIC ACTIVE HEPATITIS - AN OBITUARY [J].
LUDWIG, J .
GASTROENTEROLOGY, 1993, 105 (01) :274-278
[29]  
MAHARAJ B, 1986, LANCET, V1, P523
[30]   COMPLICATIONS ASSOCIATED WITH PERCUTANEOUS NEEDLE-BIOPSY OF THE LIVER WHEN ONE, 2 OR 3 SPECIMENS ARE TAKEN [J].
MAHARAJ, B ;
BHOORA, IG .
POSTGRADUATE MEDICAL JOURNAL, 1992, 68 (806) :964-967