Natural course of progression of liver fibrosis in Japanese patients with chronic liver disease type C - a study of 527 patients at one establishment

Patients with chronic hepatitis C infection show a gradual progression of f ibrosis to liver cirrhosis and hepatocellular carcinoma (HCC). We studied w hether the progression of liver fibrosis differed among Japanese subjects w ho were infected with different hepatitis C virus (HCV) genotypes. In 527 p atients we examined whether there was a relationship between gender, age, h istory of blood transfusion, interval between date of blood transfusion and date of liver biopsy or date of diagnosis of HCC, serum alanine aminotrans ferase level, platelet count or HCV genotype, with the extent of liver fibr osis, classified into four stages (F1-F4). Moreover, we compared the mean r ate of liver fibrosis progression per year in patients with each HCV genoty pe. Patients who had a higher fibrosis score tended to be older, have a low er platelet count and a longer interval since blood transfusion than those who had a lower fibrosis score. The mean rate of liver fibrosis progression was 0.12 +/- 0.15 stages per year after the blood transfusion. However, th e progression rate of liver fibrosis in patients who had received a blood t ransfusion when they were greater than or equal to 30 years of age was 0.19 +/- 0.22, while the progression rate of liver fibrosis in the patients who had received a blood transfusion when they were < 30 years was 0.09 +/- 0. 09. In conclusion, chronic hepatitis C is a progressive disease, and patien ts with genotype 1b, 2a and 2b have a similar rate of progression of liver fibrosis. Particular attention should be paid to patients who are infected with HCV when greater than or equal to 30 years of age, because intrahepati c fibrosis rapidly progresses in these patients.