Prevalence of Liver Disease in a Population of Asymptomatic Persons with Hepatitis C Virus Infection

  1. Alfredo Alberti, MD;
  2. Franco Noventa, MD;
  3. Luisa Benvegnù, MD;
  4. Silvia Boccato, MD; and
  5. Angelo Gatta, MD
  1. From University of Padova, Padova, Italy.

    Abstract

    Background: The prevalence of significant liver disease in persons with asymptomatic hepatitis C virus (HCV) infection is unclear.

    Objective: To determine the prevalence and severity of HCV infection in asymptomatic persons.

    Design: Population-based cross-sectional study.

    Setting: Northeastern Italy.

    Patients: 4820 apparently healthy Telecom Italy employees or their relatives who underwent screening for cardiovascular risk factors.

    Measurements: Initial screening for anti-HCV by enzyme-linked immunosorbent assay followed by HCV RNA testing by polymerase chain reaction and monitoring of alanine aminotransferase levels in viremic persons (92% of viremic persons also had liver biopsies to assess their METAVIR scores).

    Results: 116 persons (2.4% [95% CI, 1.97% to 2.84%]) were positive for anti-HCV and 85 (1.76% [CI, 1.39% to 2.14%]) were also viremic. The ALT level was persistently normal in 39 (46%) of viremic patients and elevated in 46 (54%). Significant hepatic histologic abnormalities were detected in 19% (CI, 7.21% to 36.4%) of persons with persistently normal ALT levels and in 61% (CI, 45.4% to 74.9%) of viremic persons who had elevated ALT levels (P < 0.001). The prevalence of HCV infection and number of persons with chronic liver fibrosis increased with age (P = 0.003).

    Conclusions: Hepatitis C is histologically active and progressive in up to 40% of asymptomatic persons with HCV infection. The severity of liver disease correlates with abnormal ALT levels and increases with age.

    Article and Author Information

    • Grant Support: By a grant from the Consiglio Nazionale delle Ricerche (CNR), Rome, Italy.

    • Requests for Single Reprints: Alfredo Alberti, MD, Department of Clinical and Experimental Medicine, Clinica Medica 5, University of Padova, Via Giustiniani 2, 35100 Padova, Italy; e-mail, alfredo.alberti{at}unipd.it.

    • Current Author Addresses: Drs. Alberti, Noventa, Benvegnù, Boccato, and Gatta: Department of Clinical and Experimental Medicine, Clinica Medica 5, Via Giustiniani 2, 35128 Padova, Italy.

    • Author Contributions: Conception and design: A. Alberti.

    • Analysis and interpretation of the data: A. Alberti, L. Benvegnù.

    • Drafting of the article: A. Alberti.

    • Critical revision of the article for important intellectual content: A. Gatta.

    • Final approval of the article: A. Alberti, F. Noventa, L. Benvegnù, S. Boccato.

    • Provision of study materials or patients: S. Boccato.

    • Statistical expertise: F. Noventa.

    • Obtaining of funding: A. Alberti.

    • Collection and assembly of data: A. Alberti, F. Noventa.

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    1. Ann Intern Med December 17, 2002 vol. 137 no. 12 961-964
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