FACTORS ASSOCIATED WITH MORTALITY IN HEPATITIS C PATIENTS
Hepatitis C is the major cause for progressive liver disease, and afflicts approximately 158 million individuals globally1,2. It is estimated that between 2007 and 2009, the costs of treating chronic hepatitis C patients in Brazil have been over 90 million dollars, with antiviral drugs being responsible for 88% of total costs3.
Transmission occurs mainly by contact with contaminated blood and hemoderivatives, with the use of intravenous drugs being the most common risk factor. Many patients acquire the Hepatitis C Virus (HCV) with no exposition to blood. Sexual transmission, considered an improbable route, can be related to sexual practices with mucous trauma and with individuals infected with HIV4. Therefore, the most elevated rates of hepatitis C are among individuals that use injectable drugs (45% of new cases), patients with liver failure undergoing hemodialisis (prevalence varies between 6 and 38%), and hemophiliacs (antiHCV rates of 44%)5.
There still are no safe predictions on the evolution of a specific patient infected with HCV, once the differences in the evolution course of each patient depend not only on viral factors, but also depend on aspects related to the host and environment6,. However, it is known that hepatitis C evolves to the chronic form in 80% of acutely infected patients7, leading to cirrhosis, digestive hemorrhage, liver failure, liver cancer and death - representing the major cause of liver transplants along with alcoholism8.
The factors associated with hepatitis C mortality are very important for the understanding of the natural history of this infection, as well as for the prediction of which patients will present more unfavorable prognosis and which will reach more severe stages of the disease. Therefore, the current study has the objective of establishing knowledge on the factors associated with death in hepatitis C patients, to guide the monitoring of the patient by the assisting physician.
- World Health Organization. Guidelines for the screening, care and treatment of persons with hepatitis C infection. WHO Library Cataloguing-in-Publication Data 2014; 1-123
- Martins T, Narciso-Schiavon JL, Schiavon LL. Epidemiologia da infecção pelo vírus da hepatite C. Rev Assoc Med Bras. 2011;57(1):107-112.
- Blatt CR, Bernardo NLMC, Rosa JA, Bagatini F, Alexandre RF, Neto GB, et al. An Estimate of the Cost of Hepatits C Treatment for the Brazilian Health System. Value Health 2012;1(2):129-135.
- Wang X, Zhang A, Sun H. Power metabolics in diagnosis and biomarker discovery of hepatocellular carcinoma. Hepatology. 2013; 57(5):2072-2077.
- Rachel J. Wilson, Div of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. July 27, 2012 / 61(29);545-549
- Vasconcelos RR, Tengan FM, Cavalheiro NP, Ibrahim K, Pereira H, Barone AA. Factors associated with severe evolution forms of chronic infection with hepatitis C virus. Rev Soc Bras Med Trop. 2006; 39(5): 433-438.
- Alberti A, Vario A, Ferrari A, Pistis R. Review article: chronic hepatits C – natural history and cofactors. Aliment Pharmacol Ther. 2005; 22(Suppl. 2): 74-78.
- Ghany MG, Strader DB, Thomas DL, Seeff LB. Diagnosis, management and treatment of hepatitis C: an update. Hepatology. 2009; 49(4): 1335-1374.
- Sie L, Gatto NM, Bancroft E. Hospitalizations due to hepatitis C in los angeles county, 2007-2009: Case characteristics and factors associated with mortality. J Viral Hepat. 2013; 20(9): 628-37.
- Di BisceglieAM, Stoddard AM, Dienstag JL, Shiffman ML, Seeff LB, Bonkovsky HL, et al. Excess mortality in patients with advanced chronic hepatitis C treated with long-term peginterferon. Hepatology. 2011; 53(4):1100-8.
- Custro N, Caraccio A, Ganci A, Scafidi V, Campagna P, Di Prima L. Glycemic homeostasis in chronic viral hepatitis and liver cirrhosis. Diabetes Matab. 2001; 27(4 Pt 1): 476-81.
- Kabbaj N, Errabih I, Guédira M, El Atmani H, Benabed K, Al Hamany Z, et al. Hépatitevirale C etdiabète: influence du diabètesurl’évolution de l’hépatopathie. Ann Endocrinol. 2006; 67(3): 233-237.
- Papatheodoridis GV, Chrysanthos N, Savvas S, Sevastianos V, Kafiri G, Petraki K, et al. Diabetes mellitus in chronic hepatitis B and C: prevalence and potential association with the extent of liver fibrosis. J Viral Hepat. 2006; 13(5): 303–310.
- Zeng QL, Feng GH, Zhang JY, Chen Y, Yang B, Huang HH, et al. Risk factors for liver-related mortality in chronic hepatitis C patients: a deceased case-living control study. World J Gastroenterol. 2014; 20(18): 5519-5526.
- Wai CT, Greenson JK, Fontana RJ, Kalbfleisch JD, Marrero JA,Conjeevaram HS, et al. A simple noninvasive indexcanpredictbothsignificiant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003; 38(2): 518-26.)
- Anderson FH, Zeng L, Rock NR, Yoshida EM. An assessment of the clinical utility of serum ALT and AST in chronic hepatitis C. Hepatol Res. 2000; 18(1): 63-71.
- Lawson A, Hagan S, Rye K, Taguri N, Ratib S, Zaitoun AM, et al. The natural history of hepatitis C with severe hepatic fibrosis. J Hepatol. 2007; 47(1): 37-45.
- Myers RP, De Torres M, Imbert-Bismut F, Ratziu V, Charlotte F, Poynard T. Biochemical markers of fibrosis in patients with chronic hepatitis C: A comparison with prothrombin time, platelet count, and age-platelet index. Dig Dis Sci. 2003; 48(1): 146-53.
- Saad WE, Darwish WM, Davies MG, Kumer S, Anderson C, Waldman DL, et al. Transjugular intrahepatic portosystemic shunts in liver transplant recipients: technical analysis and clinical outcome. AJR Am J Roentgenol. 2013; 200(1): 210–8.
- El-mezayen HA, Darwish H. Development of a novel score for early detection of hepatocellular carcinoma among high-risk hepatitis C virus patients. Tumor Biol. 2014; 35(7): 6501–6509.
- Vasconcelos RR, Tengan FM, Cavalheiro NP, Ibranhim K, Pereira H, Barone AA. Fatores associados às formas evolutivas graves da infecção crônica pelo vírus da hepatite C. Rev Soc Bras Med Trop. 2006; 39(5): 433-438.
- Thomas DL, Seeff LB. Natural history of hepatitis C. Clin Liver Dis 2005; 9: 383-398.
- Dieperink E, Pocha C, Thuras P, Knott A, Colton S, Ho SB. All-cause mortality and liver-related outcomes following successful antiviral treatment for chronic hepatites C. Dig Dis Sci. 2014; 59(4): 872-880.
- Mourad A, Burban SD, Carrié NG, Vantroys TR, Rosa I, Bouvier AM, et al. Hepatocellular Carcinoma screnning in patients with compensated hepatitis C virus (HCV) – related cirrhosis aware of their HCV status improves survival: a modeling approach. Hepatology. 2014; 59(4): 1471-1481.
- Marabita F, Aghemo A, De Nicola S, Rumi MG, Cheroni C, Scavelli R, et al. Genetic variation in the interleukin-28B gene is not associated with fibrosis progression in patients with chronic hepatitis C and known date of infection. Hepatology 2011; 54(4):1127-34.
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