Patients infected with the hepatitis C virus who are otherwise healthy may have a lower risk of serious liver disease than previously thought, report US researchers. Previous studies from liver transplant centers suggested that infection with hepatitis C virus (HCV) was highly likely to result in cirrhosis, liver failure, or cancer of the liver, though there have been few long-term studies of HCV patients. Now, in a study conducted by Dr. Leonard Seeff from the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland and colleagues, nearly 9,000 blood samples and medical records have been examined to determine the outcome of HCV infection in military recruits tested more than 45 years ago.
The results show that out of 8,568 persons tested, only 34 showed evidence of HCV, an infection rate of only 0.4%. For reasons that remain unclear, the authors note, the rate of HCV infection among African Americans was 26 times that of white persons. Looking at the medical records of these recruits over the last 45 years, the investigators found that hospital admission rates among participants positive for HCV and for those who were HCV negative were the same. Only one HCV-positive patient had a record of chronic liver disease and cirrhosis, the report indicates, and there were no HCV-positive patients with a history of liver cancer. Death rates overall were somewhat higher among the HCV-positive individuals (41%) than among those without HCV (26%), though the average ages at death were not significantly different, according to the report.
One of the six deaths among HCV-positive persons was from liver disease (17%), compared to only 6% liver-related deaths among the HCV-negative group. Despite the relatively small number of HCV-positive persons identified the authors conclude that their results indicate that progressive liver disease in persons with HCV infection is not inevitable. They note that less than 15% of HCV-positive persons went on to develop chronic liver disease.
Annals of Internal Medicine January 18, 2000;132:105-111.