Alfredo Alberti, MD; Franco Noventa, MD; Luisa Benvegnù, MD; Silvia Boccato, MD; Angelo Gatta, MD
The prevalence of significant liver disease in persons with asymptomatic hepatitis C virus (HCV) infection is unclear.
To determine the prevalence and severity of HCV infection in asymptomatic persons.
Population-based cross-sectional study.
4820 apparently healthy Telecom Italy employees or their relatives who underwent screening for cardiovascular risk factors.
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).
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).
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.
Alberti A, Noventa F, Benvegnù L, et al. Prevalence of Liver Disease in a Population of Asymptomatic Persons with Hepatitis C Virus Infection. Ann Intern Med. 2002;137:961–964. doi: 10.7326/0003-4819-137-12-200212170-00009
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Published: Ann Intern Med. 2002;137(12):961-964.
Gastroenterology/Hepatology, Infectious Disease, Liver Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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