Risk factors of unfavorable prognosis of chronic hepatitis C

Autor: E Z Burnevich, S V Мoiseev, A L Filatova, N A Мukhin, S E Shchanitcyna, E N Nikulkina
Jazyk: ruština
Rok vydání: 2019
Předmět:
0301 basic medicine
Vasculitis
History
medicine.medical_specialty
Cirrhosis
Carcinoma
Hepatocellular
Lymphoma
B-Cell
Endocrinology
Diabetes and Metabolism
liver cirrhosis
lcsh:Medicine
Gastroenterology
Antiviral Agents
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diabetes mellitus
medicine
Humans
risk factors
Decompensation
Treatment Failure
Cryoglobulinemic vasculitis
Retrospective Studies
business.industry
Liver Neoplasms
lcsh:R
b-cell lymphome
Retrospective cohort study
General Medicine
Odds ratio
hepatocellular carcinoma
Hepatitis C
Chronic
medicine.disease
Prognosis
Lymphoma
030104 developmental biology
predictors
Cryoglobulinemia
decompensation of cirrhosis
Hepatocellular carcinoma
cryoglobulinemic vasculitis
chronic hepatitis c
030211 gastroenterology & hepatology
Family Practice
business
Zdroj: Терапевтический архив, Vol 91, Iss 2, Pp 59-66 (2019)
ISSN: 2309-5342
0040-3660
Popis: Aim. To investigate risk factors of unfavorable prognosis in patients with chronic hepatitis C (CHC), including liver cirrhosis (LC), decompensated cirrhosis, hepatocellular carcinoma (HCC), cryoglobulinemic vasculitis (CryoVas) and B-cell non-Hodgkin’s lymphoma. Materials and methods. This was a retrospective study using data of 824 patients with CHC hospitalized between 2010 and 2016 in clinic named after E.M. Tareev. We used multivariate analysis including logistic regression to calculate odds ratios (ORs) for potential risk factors/predictors associated with unfavorable outcomes in patients with CHC. Results and discussion. The rate of LC, decompensated LC, HCC, serious CryoVas and B-cell lymphoma in patients with CHC was 39.1% (322/824), 14.0% (115/824), 2.8% (23/824), 5.2% (43/824) and 1.2% (10/824), respectively. After adjustment for sex and age the rate of LC, decompensated LC, HCC was 22.8, 8.0 and 1.5%, respectively. Annual rate of LC in patients with CHC was 1.5%; in cirrhotic patients annual rate of decompensated LC and HCC was 2.9 and 1%, respectively. Risk factors independently associated with development of LC were elevated body mass index (OR 1.43), immunosuppressive therapy (OR 1.67), diabetes type 2 (OR 2.03), absence of antiviral therapy (OR 2.15), alcohol abuse (OR 2.34), duration of infection ≥20 years (ОR 2.74) and an absence of sustained virological responce (SVR) (OR 2.98). Independent risk factors for decompensation in cirrhotic patients included diabetes type 2 (OR 1.47), alcohol abuse (OR 1.53), an absence of antiviral therapy (OR 2.36) and an absence of SVR (OR 1.94). An episode of decompensation was the independent predictor of HCC in cirrhotic patients (OR 3.99). Genotype 1b (OR 1.66) and an absence of antiviral therapy (OR 3.31) were independently associated with serious CryoVas. Two prognostic scales were offered for risk evaluation of LC and its complications. Conclusions. Multivariate analysis showed several factors independently associated with higher risk for LC, decompensation of LC, HCC, serious CryoVas in patients with CHC. The rate of unfavorable outcomes of CHC is found, including rare extrahepatic manifestations.
Databáze: OpenAIRE
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