Progression of liver fibrosis among injection drug users with chronic hepatitis C†

• DOI: 10.1002/hep.21091
• Publication Date: 2006-03-23T23:49:28Z
• Authors: Lucy E. Wilson; Michael Torbenson; Jacquie Astemborski; Hawazin Faruki; Charles Spoler; Rudra Rai; Shruti Mehta; Gregory D. Kirk; Kenrad Nelson; Nezam Afdhal; David L. Thomas
• Keywords: Hepatitis C; Liver disease

Although most hepatitis C virus (HCV) infections are acquired by injection drug use, prospective data on the progression of liver fibrosis sparse. Baseline biopsies were obtained (1996-1998) a random sample 210 out 1667 HCV-positive users (IDUs). Subjects followed biannually, with second biopsy offered to those eligible. Paired scored 0 6 (modified Ishak score), significant was defined as score 3 or greater, and an increase 2 more units clinical evidence end-stage disease. Predictive values blood markers [FibroSURE, aspartate aminotransferase-to-platelet-ratio index (APRI) alanine aminotransferase (ALT)] assessed for detection contemporaneous future fibrosis. Among 119 prospectively IDUs, 96% African American; 97% HCV genotype 1a/b; 27% HIV-infected, median age 42 years. Most (90.7%) did not have at first biopsy. predictive value detecting insignificant greater than 95% FibroSURE, APRI, ALT, specificities 88.9%, 72.7%, respectively. After 4.2 years follow-up, 21% had fibrosis, which significantly associated serum level RNA ALT. No serological test 40% Even initial result only 30.4% predicting In conclusion, detected in some, but most, IDUs this cohort. setting low prevalence, APRI tests predict fibrosis; however, further work is needed find noninvasive