The long term outcomes of community acquired hepatitis C infection in a cohort with sera stored from 1971-1975

Rodger, Alison J (2001) The long term outcomes of community acquired hepatitis C infection in a cohort with sera stored from 1971-1975. MD thesis, University of Glasgow.

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Abstract

Aim: To examine the long term outcomes of hepatitis C virus (HCV) infection in a cohort of patients admitted with acute viral hepatitis between 1971 and 1975. The availability of stored sera enabled testing to identify anti-HCV positive subjects. Methods: A retrospective cohort study design was chosen. The exposure of interest was the presence of anti-HCV in stored sera. Systematic approaches were used to locate the cohort and outcomes assessed with the SF-36 questionnaire, a study specific questionnaire and by clinical, serological, virological and biochemical assessment. Results: Sixteen percent (n=238) of the cohort tested anti-HCV positive and formed the exposed group. The unexposed group (n=476) was randomly selected from those who were anti-HCV negative. Complete follow up was achieved on 98 anti- HCV positive individuals and 202 negatives. At 25 years follow-up, 54% of the anti-HCV positive group had evidence of chionic HCV infection (both anti-HCV and HCV RNA positive). Of those chronically infected 69% had elevated serum ALT levels, but only 8% had progressed to overt chronically and no cases of HCC were identified. Anti-HCV positive subjects were 4 times more likely to have died from suicide or drug overdose than from HCV related disease. Quality of life measures were significantly reduced in the exposed group and significantly worse for anti-HCV positive individuals aware of their serostatus, compared to those unaware. Discussion: The reduced quality of life in those aware of their HCV diagnosis may be partially an effect of 'labelling'. Anti-HCV positive study subjects were at increased risk of liver related pathology after 25 years follow up, but few had progressed to overt cirrhotic liver disease- Excess mortality in the anti-HCV positive group was not due to liver disease. This suggests that the natural history of community acquired HCV may be more benign than previously thought.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Epidemiology, Virology
Date of Award: 2001
Depositing User: Enlighten Team
Unique ID: glathesis:2001-73661
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 14 Jun 2019 08:56
Last Modified: 14 Jun 2019 08:56
URI: http://theses.gla.ac.uk/id/eprint/73661

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