Natural history of hepatitis C in Thailand

Natural history of hepatitis C in Thailand

Mongkol Hongsirinirachorn, D. of Medicine, Pramongkutklao Hospital, Bangkok
Chutima Pramoolsinsap, Prof., D. of Medicine, F. of Medicine, Ramathibodi Hospital, Bangkok
Taweesak Tanwandee, Asst. Prof., D. of Medicine, F.of Medicine, Siriraj Hospital, Bangkok
Teerha Piratvisuth, Assoc. Prof., D. of Internal Medicine, F. of Medicine, PSU.
Varocha Mahachai, Assoc. Prof., D. of Medicine, F. of Medicine, Chulalongkorn Hospital, Bangkok
Anuchit Chrtaputti, D. of Medicine, Pramongkutklao Hospital, Bangkok
Corresponding e-mail : ptimmy@ratree.psu.ac.th

Published : J Gastroenterol Hepatol, 1999 14(Suppl.) S96
Key words : HCV, natural history

Objective : The reports of natural course of hepatitis C viral infection in Thailand were scat-tering and only few patients were included. This is historical study by multi-centers in Thailand to analyze patients who acquired chronic hepatitis C (HCV) and provide insight into the natural history of chronic HCV infection.

Methods : Between 1991-1999, there were 323 Thai patients (Mean age = 45.4; range 17-77) attended GI clinic of five medical schools. To evaluate the modes of acquisition of HCV, morbidity/mortality with rate of progression from transfusion-associated patients and clinical outcome of chronic hepatitis C established chronic liver disease.

Results : The mode of transmission assessed in transfusion-associated IVDU : sporadic routes were 53.3% : 5.2% : 41.5%. The interval between date of transfusion -associated infection and diag- nosis of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC) was 10.1, 15.4 and 19.6 years. Median progression rate from transfusion-associated hepatitis C to cirrhosis and HCC were 8.5% and 6.5% after 7.8 years of follow-up. Even most patients were asymptomatic, the clinical outcome of chronic hepatitis progress to cirrhosis and HCC were 11.8% and 4.6% with the mean follow-up of 4.8 years.

Conclusions : HCV infection in Thailand can also result in prognostic spectrum of liver diseases from subclinical feature to cirrhosis and HCC. The transfusion-associated hepatitis C from onset of acute disease to HCC seems more progressive than other studies. Viral genotype may be important role in determining the clinical outcome of hepatitis C virus related chronic liver diseases in Thailand.

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