Predictors of disease progression

• Predictors of HCV disease progression include:
  • alcohol consumption
    • alcohol is strongly associated with increased likelihood of progression to severe liver complications
    • progression to cirrhosis is higher in those who drink excessively
    • faster progression is found in those who have previously drunk more than 50 units of alcohol a week for more than five years
  • age at infection
    • patients who acquire hepatitis C at an older age have a more rapidly progressing disease and reduced time from infection to cirrhosis
  • gender
    • men are more likely to progress to cirrhosis than women
  • ethnicity
    • chronic hepatitis C appears to progress less rapidly in African-American patients than non African-American patients
    • the disease may be worse in Asian patients
  • co-infection with human immunodeficiency virus (HIV) or hepatitis A and/or B
    • patients who are also co-infected with either HIV and/or hepatitis B and/or A are likely to progress to serious disease more rapidly
  • viral genotype
    • no effect on disease progression but different genotypes have different sensitivities to therapy
  • weight
    • body mass index above 25 has been associated with hepatic steotosis and, in some studies, more rapid disease progression
  • smoking
    • smoking is an independent risk factor of hepatic inflammation in patients with chronic hepatitis C

Reference:

1. RCGP (2007).Guidance for the prevention, testing, treatment and management of hepatitis C in primary care.