Natural history and etiology of liver disease in patients with previous community-acquired acute non-A, non-B hepatitis - A follow-up study of 178 Danish patients consecutively enrolled in The Copenhagen Hepatitis Acuta Programme in the period 1969-1987

Background/Aims: Consecutive patients originally diagnosed with acute non-A , non-B hepatitis were followed up to assess the long-term morbidity and mo rtality and to re-evaluate the etiology in surviving patients. Methods: Follow-up was performed in 178 patients with acute non-A, non-B he patitis enrolled in the Copenhagen Hepatitis Acuta Programme in the period 1969-1987. Mortality and morbidity were assessed using: i) death certificat es and ii) diagnoses at discharge following all somatic admissions. All pat ients who were alive were offered a re-examination encompassing clinical, b iochemical and virological evaluation. Results: After a median of 23 years, 71 (40%) had died and seven (4%) were untraceable. Overall mortality and mortality due to cirrhosis and accidents , mainly intoxication with drugs, were significantly higher compared to tho se of an age- and sex-matched Danish population. Chronic hepatitis had been diagnosed in 19 (11%) and cirrhosis in 16 (9%). Of 100 patients who were a live, 57 accepted a re-examination. Anti-HCV was detected in 24 (42%) and 1 9 (33%) were HCV-RNA positive. Of the viremic patients, 11 (58%) had elevat ed P-ALT, but only three (16%) had already been diagnosed with HCV infectio n. A history of intravenous drug use was tantamount to anti-HCV positivity. Conclusions: Danish patients with community-acquired acute non-A, non-B hep atitis had an increased mortality due to liver cirrhosis during the first y ears after the acute infection. Alcohol was the etiological agent in severa l cases, but HCV infection may also have been present. However, the long-te rm HCV-related morbidity and mortality were low.