The natural history of 'healthy-HCV carriers'

September 24, 2008

A normal liver is observed in about 10% of HCV infected patients and the natural history of theses so-called "healthy-HCV carriers" is not fully defined.

An article published on 28 June 2008, in the World Journal of Gastroenterology addresses the question of the evolution of theses "healthy-HCV carriers". In this research lead by Dr Sobesky R and his colleagues from the Unit of Hepatology, Hospital Cochin, Paris, the authors try to determine factors associated with fibrosis progression in HCV-infected patients without significant initial pathological lesions.

After a median interval of 4 years, there is no fibrosis progression in 66% of patients. By multivariate analysis, fibrosis progression was associated with elevated transaminases, body mass index upper to 25, and the time interval between 2 biopsies.

This study confirms the concept that the natural history of chronic hepatitis in this group of subjects is characterized by a very slow or no fibrosis progression. We can differentiate in these "asymptomatic carriers" a sub-group of patients with elevated transaminases and overweight, which is exposed to fibrosis progression. Moreover, theses patients with a higher risk of liver fibrosis progression should receive an antiviral therapy. HCV-infected patients with overweight should be informed of the risk of liver fibrosis progression and the need of dietetic councils.

World Journal of Gastroenterology

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