West J Med 1996 May;164(5):399-404
Clinical sequelae of Hepatitis C acquired from injection
drug use.
Tong MJ, el-Farra NS
Liver Center, Huntington Memorial Hospital, Pasadena, CA 91105, USA.
We determined the course of Hepatitis C infection in 125 patients with a history
of injection drug use. The mean age at presentation was 43.5 years, and the
mean age of initiating injection drug use was 23.1 years. Fatigue and hepatomegaly
were present in as many as 60% of patients. All had antibodies to the Hepatitis
C recombinant protein C25, and 99% were positive for Hepatitis C virus RNA.
After the initial workup, 33 (26%) patients had chronic hepatitis, 46 (37%)
had chronic active hepatitis, 45 (36%) had cirrhosis, and 1 (0.8%) presented
hepatocellular carcinoma. During follow-up, hepatocellular carcinoma developed
in 2 other patients. In 74 patients with a 1-year history of injection drug
use, the mean number of years to the development of chronic hepatitis, chronic
active hepatitis, cirrhosis, and hepatocellular carcinoma were 15.6, 17.6, 19.4,
and 26.3 years, respectively. In this subgroup of patients, heavy alcohol abuse
did not appear to influence the progression of liver disease. The 2-year case-fatality
rate was 2%. Our findings indicate that Hepatitis C is a progressive disease,
but only a few died during the average 20.4 years after the initiation of injection
drug use. Antiviral treatment to eradicate the virus and halt the progression
of disease is indicated in this group of patients.
PMID: 8686295, UI: 96280428
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