MORBIDITY OF CHRONIC HEPATITIS-C AS SEEN IN A TERTIARY CARE MEDICAL-CENTER

We studied the morbidity of chronic hepatitis C in patients referred t o a tertiary care medical facility. The medical records of 500 consecu tive cases of chronic hepatitis C were examined for the following: (1) source and time of exposure, (2) signs and symptoms of liver disease, (3) degree of alcohol intake, (4) liver biopsy findings, (5) extrahep atic disease manifestations, and (6) coexisting illnesses that could h ave an impact on morbidity. Morbidity and histologic findings were eva luated in relation to the duration of hepatitis C. The onset of infect ion could be determined in 376 patients (75%). A dose relationship bet ween the length of infection and disease features was not observed. Fa tigue was common at all stages of infection. Whereas cirrhosis occurre d more frequently in patients with disease of long duration, 15-24% of patients had signs of advanced liver disease (ascites, encephalopathy , thrombocytopenia) within six years of exposure. Overt extrahepatic m anifestations of chronic hepatitis C occurred infrequently, and depres sion was reported in 24% of untreated patients. In conclusion, in pati ents referred to a tertiary care setting, chronic hepatitis C is often associated with significant morbidity.