| Objective: To investigate the prognosis of hepatitis C virus infection and influencing factors for the progression of liver fibrosis.Method:A retrospective investigation on patients with hepatitis C virus infection was carried out in an area of Northeast China.The main cause of hepatitis C virus infection in these patients was the sharing of syringe injections in the late 1970 s and early 1980 s.873 patients(571males,302 females,with an average of53.89 ±8.147 years)who underwent had been infected with Hepatitis C virus infection.various clinical and laboratory data were evaluated to determine the influencing factors for progression of liver fibrosis in 2014.873 patients were divided into self-healing group and chronic infection group(including untreated groups,SVR groups and no-SVR groups),Of the 771 CHC patients,425 patients had received IFN/RBV treatment in the form of subcutaneous injections of recombinant interferon-?2b(5MU,three times/week;Beijing Kawin Technology Share-holding Co,Ltd.,Beijing,China)and oral ribavirin(900 mg/day)for at least 12 weeks.Fibro Scan value was used as the diagnostic criterion for hepatic fibrosis,progress of hepatic fibrosis and occurrence of liver cancer were analysised in each group.The correlation between various factors and Fibro Scan value was analyzed and the related factors affecting the progression of hepatic fibrosis were explored.Result:A total of 873 individuals were investigated in an area of Northeast China,the Self-healing rate was 11.7%(102/873)and chronic HCV infection rate was88.3%(771/873);the Self-healing rate of women(18.2%)was significantly higher than that in men(8.2%)and the chronic rate of males(91.8%)was significantly higher than that of female(81.8%).425 people received antiviral therapy,of which 242(56.9%)received SVR.After 30 to 40 years of HCV infection,124 patients(14.2%)developed significant(F?3)fibrosis;In untreated groups,there were 163 patients(41.7%)progressed to liver fibrosis in the stage of F0,and 77 patients(22.3%)to F1,and 30 patients(8.7%)to F2,and 41 patients(11.8%)to F3,and 35 patients(10.1%)(including1 patient with liver cancer)to F4;In self-healing group,there were 84 patients(82.4%)progressed to liver fibrosis in the stage of F0,and 7 patients(6.9%)to F1,and 4 patients(3.9%)to F2,and 5 patients(4.9%)to F3,and 2 patients(2.0%)to F4;In SVR groups,there were 186 patients(77.2%)progressed to liver fibrosis in the stage of F0,and 29 patients(12.0%)to F1,and 11 patients(4.6%)to F2,and 9 patients(3.7%)(including 1 patient with liver cancer)to F3,and 6 patients(2.5%)to F4;In no-SVR groups,there were 102 patients(55.4%)progressed to liver fibrosis in the stage of F0,and 40 patients(21.7%)to F1,and 16 patients(8.7%)to F2,and 10 patients(5.4%)to F3,and 16patients(8.7%)to F4;The difference of hepatic fibrosis in each group was statistically significant(P < 0.001).The degree of liver fibrosis in the self-healing group was significantly lighter than non-SVR group and the untreated group(P<0.001).And the SVR group was lighter than the untreated group and the untreated group(P<0.001).And the non-SVR group was lighter than the untreated group(P<0.05).Sex,age,platelet,glucose were correlated with fibroscan value(Table 1).In Logistic regression analysis,age,sex,hyperglycaemia,prognosis situation were associated with the progression of liver fibrosis.Men were more likely to developed significant(F?3)fibrosis.Male gender(OR = 1.594,95 % CI:1.028–2.474),older age(OR = 3.999,95 % CI:1.766–9.056),hyperglycaemia(OR = 2.635,95 % CI:1.398–4.969);Factors negatively associated with the progression of liver fibrosis were self-healing(OR = 0.317,95 % CI: 0.140–0.721),SVR(OR = 0.263,95 % CI:0.145–0.477)no-SVR(OR = 0.592,95 % CI: 0.360–0.973)(Table 4)Conclusions: Hepatitis C virus infection,average course was 30-40 years,only 11.7% of the patients were self-healing,the female self-healing rate was higher.21.9% of the patients with CHC with an course of 30-40 years had developed to significant(F?3)fibrosis(including a liver cancer).The level of fibrosis in SVR group(patients who received IFN/RBV treatment)was equivalent to the self-healing group.old age,male gender,untreated and hyperglycaemia were found to be independent risk factors associated with the progression of liver fibrosis... |
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