Natural history of acute hepatitis C
Natural history of acute hepatitis C
复制标题
急性丙型肝炎的自然史
DOI：
--
复制
发表时间：
2000
影响因子：
4.1
通讯作者：
K. Kiyosawa
中科院分区：
文献类型：
--
作者：
E. Tanaka;K. Kiyosawa
为了研究急性丙型肝炎的短期和长期结果，招募了三组患者。在 26 名急性丙型肝炎患者中，18 名（69%）维持 HCV 病毒血症，8 名在发病后 12 个月时病毒自然清除。所有 8 名急性消退性肝炎患者中 ALT 均正常化，但 18 名慢性 HCV 感染患者中只有 1 名 (5%) 正常化 (P < 0.001)。对 43 名接受重复肝活检的急性丙型肝炎患者的肝脏组织学变化进行了分析。发病1年内纤维化阶段平均评分为0.9，发病30年后逐渐升至3.5（0.1级/年）。 50岁以上的患者纤维化阶段增加得更快。在 115 名患者中，随着输血年龄的增加，从输血到诊断出 HCC 的平均时间显着增加 (P < 0.001)； 30岁以下患者为35±5.3岁，30至40岁患者为30±4.9岁，40岁以上患者为25±6.8岁。总之，大约 70% 的急性丙型肝炎患者会发展为慢性肝炎。一旦患者出现肝脏慢性肝纤维化，其进展会持续数十年，老年患者的进展速度更快。
To study the short‐ and long‐term outcomes of acute hepatitis C, three groups of patients were enrolled. Of 26 patients with acute hepatitis C, 18 (69%) maintained HCV viraemia and 8 had cleared virus naturally at 12 months after the onset. Normalization of ALT was seen in all 8 patients with acute resolving hepatitis, but in only 1 (5%) of the 18 patients with chronic HCV infection (P < 0.001). Changes in liver histology were analysed in 43 patients with acute hepatitis C who underwent repeated liver biopsy. The mean score of the fibrotic stage was 0.9 within 1 year of the onset, and it increased gradually up to 3.5 at 30 years from the onset (0.1 grade/year). The fibrotic stage increased more rapidly in patients aged more than 50 years. In 115 patients, the mean duration between blood transfusion and the diagnosis of HCC increased significantly (P < 0.001) in accordance with increasing age at blood transfusion; 35 ± 5.3 years in patients aged less than 30 years, 30 ± 4.9 years in those aged between 30 and 40 years, and 25 ± 6.8 years in those aged more than 40 years. In conclusion, approximately 70% of patients with acute hepatitis C develop chronic hepatitis. Once patients develop chronic hepatitic fibrosis of the liver, it progresses over several decades, faster in older patients.