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

An article published 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.



Reference: Sobesky R, Lebray P, Nalpas B, Vallet-Pichard A, Fontaine H, Lagneau JL, Pol S. Pathological evolution of hepatitis C virus - "Healthy carriers". World J Gastroenterol 2008; 14(24): 3861-3865 wjgnet/1007-9327/14/3861.asp

Correspondence to: Rodolphe Sobesky, INSERM U 785, Centre Hépato-Biliaire, Hôpital Paul Brousse, Villejuif 94807, France.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection. It provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the title China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

Source: Lai-Fu Li
World Journal of Gastroenterology