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Prevalence of Liver Disease in a Population of Asymptomatic Persons with Hepatitis C Virus Infection

Alfredo Alberti, MD; Franco Noventa, MD; Luisa Benvegnù, MD; Silvia Boccato, MD; and Angelo Gatta, MD
[+] Article, Author, and Disclosure Information

From University of Padova, Padova, Italy.

Grant Support: By a grant from the Consiglio Nazionale delle Ricerche (CNR), Rome, Italy.

Requests for Single Reprints: Alfredo Alberti, MD, Department of Clinical and Experimental Medicine, Clinica Medica 5, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; e-mail, alfredo.alberti@unipd.it.

Current Author Addresses: Drs. Alberti, Noventa, Benvegnù, Boccato, and Gatta: Department of Clinical and Experimental Medicine, Clinica Medica 5, Via Giustiniani 2, 35128 Padova, Italy.

Author Contributions: Conception and design: A. Alberti.

Analysis and interpretation of the data: A. Alberti, L. Benvegnù.

Drafting of the article: A. Alberti.

Critical revision of the article for important intellectual content: A. Gatta.

Final approval of the article: A. Alberti, F. Noventa, L. Benvegnù, S. Boccato.

Provision of study materials or patients: S. Boccato.

Statistical expertise: F. Noventa.

Obtaining of funding: A. Alberti.

Collection and assembly of data: A. Alberti, F. Noventa.

Ann Intern Med. 2002;137(12):961-964. doi:10.7326/0003-4819-137-12-200212170-00009
Text Size: A A A

Background: The prevalence of significant liver disease in persons with asymptomatic hepatitis C virus (HCV) infection is unclear.

Objective: To determine the prevalence and severity of HCV infection in asymptomatic persons.

Design: Population-based cross-sectional study.

Setting: Northeastern Italy.

Patients: 4820 apparently healthy Telecom Italy employees or their relatives who underwent screening for cardiovascular risk factors.

Measurements: Initial screening for anti-HCV by enzyme-linked immunosorbent assay followed by HCV RNA testing by polymerase chain reaction and monitoring of alanine aminotransferase levels in viremic persons (92% of viremic persons also had liver biopsies to assess their METAVIR scores).

Results: 116 persons (2.4% [95% CI, 1.97% to 2.84%]) were positive for anti-HCV and 85 (1.76% [CI, 1.39% to 2.14%]) were also viremic. The ALT level was persistently normal in 39 (46%) of viremic patients and elevated in 46 (54%). Significant hepatic histologic abnormalities were detected in 19% (CI, 7.21% to 36.4%) of persons with persistently normal ALT levels and in 61% (CI, 45.4% to 74.9%) of viremic persons who had elevated ALT levels (P < 0.001). The prevalence of HCV infection and number of persons with chronic liver fibrosis increased with age (P = 0.003).

Conclusions: Hepatitis C is histologically active and progressive in up to 40% of asymptomatic persons with HCV infection. The severity of liver disease correlates with abnormal ALT levels and increases with age.


Grahic Jump Location
Histologic activity and fibrosis stage of the 78 persons with normal or elevated alanine aminotransferase levels who were positive for hepatitis C virus.

A = necroinflammatory activity; ALT = alanine aminotransferase; F = fibrosis score.

Grahic Jump Location




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Summary for Patients

Liver Disease in Persons with Asymptomatic Hepatitis C Virus Infection

The summary below is from the full report titled “Prevalence of Liver Disease in a Population of Asymptomatic Persons with Hepatitis C Virus Infection.” It is in the 17 December 2002 issue of Annals of Internal Medicine (volume 137, pages 961-964). The authors are A Alberti, F Noventa, L Benvegnù, S Boccato, and A Gatta.


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