Chronic hepatitis C among patients from Department of Infectious Diseases in Gdańsk –epidemiology and some clinical aspects
K. Sikorska, E. Lakomy, Z. Michalska, P. Stalke, K. Witczak-Malinowska
Med Sci Monit 2003; 9(2): 15-
Background:The aim of the study was to perform epidemiological and clinical evaluation among patients with diagnosis of chronic hepatitis C,that were admitted to Department of Infectious Diseases to qualify to antiviral treatment in 1999-2002 yrs.Material/Methods:Retrospective analysis of 255 cases with collection of demographical and epidemiological data was made. We analysed inflammatory activity and fibrosis stage in histopathological examination of the liver specimen and frequency of extrahepatic manifestation of HCV infection.Results:There were 165 men and 89 women,from 18 to 68 yrs,the most often in age of 30 –50yrs.Inoculation was confirmed among 130 patients (51%),27 were health care workers (10.6%).HCV infection among patients without typical symptoms of hepatitis was suspected in 31 cases (12.2%)on routine examinations at place of work or on screening at Blood Donation Centre.Among 34 patients (13.3%)abnormal liver function tests were detected during diagnosis or treatment because of other diseases.The most often interval from probable inoculation to the moment of ascertainment of chronic hepatitis C was 10 –20 yrs.22 (8.6%)patients with chronic hepatitis C were treated previously because of acute hepatitis C.The average time that passed from appearance of first symptoms to determine indications to antiviral treatment in the whole group was contained between 5-10yrs. Histopathological evaluation of liver revealed mostly moderate grade of fibrosis and necroinflammatory process.Cirrhosis was diagnosed in 14 cases (5.5%).Extrahepatic manifestation of HCV infection was diagnosed in 29/255 cases (11.4%)(4 cases of porphyria cutanea tarda,1 case of neurodermitis,1 case of Duhring disease and 23 cases of cryoglobulinemia with symptoms of vasculitis /8/,reactive arthritis /8/and thrombocyto- penia /7/). Conclusions: 1.Clinical course of chronic hepatitis C is often occult and symptomless with slow progression to cirrhosis in some cases 2. Accurate diagnosis of this disease is established after many years from the moment of probable inoculation in great number of cases.3.Qualification to antiviral treatment sometimes is delayed because of nonspecific symptoms or late proper diagnosis.4.HCV infection relatively often takes a course with extrahepatic manifestation.