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Ann Intern Med. 2002 Dec 17;137(12):961-4.

Prevalence of liver disease in a population of asymptomatic persons with hepatitis C virus infection.

Author information

1
Department of Clinical and Experimental Medicine, Clinica Medica 5, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. alfredo.alberti@unipd.it

Abstract

BACKGROUND:

The prevalence of significant liver disease in persons with asymptomatic hepatitis C virus (HCV) infection is unclear.

OBJECTIVE:

To determine the prevalence and severity of HCV infection in asymptomatic persons.

DESIGN:

Population-based cross-sectional study.

SETTING:

Northeastern Italy.

PATIENTS:

4820 apparently healthy Telecom Italy employees or their relatives who underwent screening for cardiovascular risk factors.

MEASUREMENTS:

Initial screening for anti-HCV by enzyme-linked immunosorbent assay followed by HCV RNA testing by polymerase chain reaction and monitoring of alanine aminotransferase levels in viremic persons (92% of viremic persons also had liver biopsies to assess their METAVIR scores).

RESULTS:

116 persons (2.4% [95% CI, 1.97% to 2.84%]) were positive for anti-HCV and 85 (1.76% [CI, 1.39% to 2.14%]) were also viremic. The ALT level was persistently normal in 39 (46%) of viremic patients and elevated in 46 (54%). Significant hepatic histologic abnormalities were detected in 19% (CI, 7.21% to 36.4%) of persons with persistently normal ALT levels and in 61% (CI, 45.4% to 74.9%) of viremic persons who had elevated ALT levels (P < 0.001). The prevalence of HCV infection and number of persons with chronic liver fibrosis increased with age (P = 0.003).

CONCLUSIONS:

Hepatitis C is histologically active and progressive in up to 40% of asymptomatic persons with HCV infection. The severity of liver disease correlates with abnormal ALT levels and increases with age.

PMID:
12484711
[Indexed for MEDLINE]

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