Rate of Fibrosis Progression and Risk Factors of Advanced Fibrosis in Volunteer Blood Donors with HCV Infection
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- Category: Vol. 80, September 2012
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Rate of Fibrosis Progression and Risk Factors of Advanced Fibrosis in Volunteer Blood Donors with HCV Infection,AHMED FAISAL, AHMED EL GOHARY and USAMA EL OKDA
Abstract
Background/Aims: Chronic hepatitis by HCV is progressive towards cirrhosis, with variable rate. We evaluated the rate of fibrosis progression (RFP), risk factors associated with advanced fibrosis (F3 and F4), and estimated the evolution time to cirrhosis.
Methods: The study included selected 31 blood donors infected only with HCV, submitted to liver biopsy at admission, and second liver biopsy within 24 month duration, the pro-gression of fibrosis stage (METAVIR)/was estimated, and the studied risk factors were analyzed among progressed and non-progressed and correlated, by Non-parametric tests and logistic regression analysis, with significance level of 5% were used.
Results: Hepatic fibrosis progressed 1 stage in 25.8%, 2 stages in 16.1%, and 3 stages in only 6.5% of the biopsied subjects. The relation between progress of fibrosis and various risk factors associated with HCV infection. The only difference of statistical significance was in relation to history of dental procedures, p=0.04. More patients with progress of fibrosis had positive history of dental procedures (93.3%), compared to only 56.3% of those without progress. and the positive hepatic serology. the best fitting model for prediction of the progress of Knodell score. It indicates that the best independent statistically significant predictors of Knodell score progress were the presence of clinical symptoms and signs, and the positive hepatic serology. The model explains 30% of the variation of Knodell score, as indicated by the value of r-square the best fitting model for prediction of the progress in fibrosis score. It shows that the best independent predictors of fibrosis score progress were the presence of clinical symp-toms and signs, and the positive history of jaundice.
Conclusion: This study suggests that RFP is extremely variable, liver fibrosis, a more advanced liver disease (dec-ompensation) was associated with a higher age at evaluation. Moreover, positive bilharzial haemoagglutination test in accidentally discovered HCV positive antibody patients was significantly associated with progression of hepatitis activity index. Moreover, progression of intralobular degeneration and HC necrosis was associated with higher body mass index.