Impact of treatment on extra hepatic manifestations in patients with chronic hepatitis C

被引:80
作者
Cacoub, P
Ratziu, V
Myers, RP
Ghillani, P
Piette, JC
Moussalli, J
Poynard, T
机构
[1] Hop La Pitie Salpetriere, Dept Internal Med, F-75651 Paris 13, France
[2] Hop La Pitie Salpetriere, Dept Hepatogastroenterol, F-75651 Paris, France
[3] Hop La Pitie Salpetriere, Dept Immunochem, F-75651 Paris 13, France
关键词
arthralgia; cryoglobulin; extrahepatic manifestation; fatigue; hepatitis C virus; myalgia;
D O I
10.1016/S0168-8278(02)00067-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Fatigue and other extra hepatic manifestations of hepatitis C have never been studied prospectively in a large cohort. The aim was to assess the prevalence of these symptoms prior to any treatment, and on prolonged follow-up in treated and untreated patients. Methods: A single-center cohort of consecutive patients with chronic hepatitis C was investigated prior to any treatment. A questionnaire was completed every 6 months for 18 months of follow-up. Results: Of 1614 patients, 431 met the inclusion criteria (56% male; age 49 years; 60% with significant fibrosis or cirrhosis; 46% with cryoglobulinemia). Seventy-six were untreated; of the treated patients, 83 were sustained responders, 47 relapsers and 225 non-responders. At baseline, fatigue and other extrahepatic manifestations were present in 254 (59%) and 225 (52%) patients. Fatigue was improved in 29 of 83 (35%) responders versus 75 of 348 (22%) patients with detectable hepatitis C virus (HCV)-RNA (P = 0.01). The impact of virologic response on fatigue persisted after adjusting for age, gender, fibrosis stage, and depression (odds ratio: 0.34, P < 0.001). A cryoglobulin was detectable in two of 34 (6%) responders versus 38 of 115 (33%) patients with detectable HCV-RNA (P < 0.001). Conclusions: In hepatitis C, a sustained virologic response is associated with a reduction in fatigue and cryoglobulin, but fatigue frequently persists despite a virologic response. (C) 2002 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.
引用
收藏
页码:812 / 818
页数:7
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