574
HEPATOBILITY
Measurement and determinants of the natural history of liver fibrosis in hepatitis C virus infection: a cross sectional and longitudinal study M Wright, R Goldin, A Fabre, J Lloyd, H Thomas, C Trepo, P Pradat, M Thursz, on behalf of the HENCORE collaboration ............................................................................................................................. Gut 2003;52:574–579
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....................... Correspondence to: Dr M Wright, Department of Medicine, Imperial College of Science, Technology, and Medicine, St Mary’s Hospital (QEQM Wing), South Wharf Road, London W2 1NY, UK;
[email protected] Accepted for publication 29 October 2002
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Introduction: The rate of development of liver fibrosis in hepatitis C virus (HCV) infection varies between individuals. This accounts for the variation in duration of progression to cirrhosis. The aims of this study were: (1) to determine whether fibrosis progresses linearly through the grading scales and (2) to identify factors which influence the rate of fibrosis. Methods: HCV infected patients who had undergone at least one liver biopsy were identified. Biopsies were scored using the modified HAI (Ishak) and METAVIR systems, which were compared. Patients were treatment naïve at first biopsy. Demographic features were examined for their relationship to fibrosis rate (defined as fibrosis stage/infection duration) using univariate and multivariate analysis. A subgroup of patients with two biopsies was examined to test the assumption that fibrosis progresses in a linear fashion. Results: A total of 917 patients were included. Male sex (p
