Systematic Review: Outcome of compensated cirrhosis due to chronic hepatitis C infection.

William Alazawi (1) , Morven Cunningham (2) , Janet Dearden (3) , Graham R Foster (2)

1 Centre for Digestive Diseases
2 Centre for Digestive Diseases
3 Department of Gastroenterology

Background and Aims Most studies evaluating chronic hepatitis C (HCV) natural history have taken the development of cirrhosis as an end-point. We performed a systematic review of the literature to establish the natural historyoutcome of compensated HCV cirrhosis. Methods A systematic literature review was performed. Only data regarding untreated, HCV monoinfected patients were included. Weighted mean annual percentage rates for death/transplantation, decompensation of cirrhosis and development of HCC were calculated. Results Thirteen papers were included. Despite some heterogeneity, we extracted data relating to 2386 patients. In compensated HCV cirrhosis the estimated annual rate of death/transplantation is 4.58%, of decompensation is 6.37% per and of HCC is 3.36%. When compared to studies of untreated patients, studies that included treated patients reported significantly lower mean annual percentage rates of HCC (2.52% versus 4.79%, P=0.02), but not decompensation (5.34% versus 7.88%, P=0.026) and death/transplantation (3.79% versus 4.62%, P=0.25). Conclusions These rates highlight the need for continued vigilance for the occurrence of HCC while confirming the relatively slow progress of compensated HCV cirrhosis. Heterogeneity in reporting means that these data may underestimate the rate of disease progression, particularly HCC development. It will be important to ensure clearer distinction between treatment responses in future studies.

Mots clés: Medicine

William Alazawi, Morven Cunningham, Janet Dearden, Graham R Foster. Systematic Review: Outcome of compensated cirrhosis due to chronic hepatitis C infection.. Alimentary Pharmacology and Therapeutics, 2010, 32 (3), pp.344. ⟨10.1111/j.1365-2036.2010.04370.x⟩. ⟨hal-00552579⟩