Natural history of decompensated hepatitis C virus-related cirrhosis. A study of 200 patients

J Hepatol. 2004 May;40(5):823-30. doi: 10.1016/j.jhep.2004.01.005.


Background/aims: Since few data are available concerning the clinical course of decompensated hepatitis C virus (HCV)-related cirrhosis, the aim of the present study was to define the natural long-term course after the first hepatic decompensation.

Methods: Cohort of 200 consecutive patients with HCV-related cirrhosis, and without known hepatocellular carcinoma (HCC), hospitalized for the first hepatic decompensation.

Results: Ascites was the most frequent first decompensation (48%), followed by portal hypertensive gastrointestinal bleeding (PHGB) (32.5%), severe bacterial infection (BI) (14.5%) and hepatic encephalopathy (HE) (5%). During follow-up (34+/-2 months) there were 519 readmissions, HCC developed in 33 (16.5%) patients, and death occurred in 85 patients (42.5%). The probability of survival after diagnosis of decompensated cirrhosis was 81.8 and 50.8% at 1 and 5 years, respectively. HE and/or ascites as the first hepatic decompensation, baseline Child-Pugh score, age, and presence of more than one decompensation during follow-up were independently correlated with survival.

Conclusions: Once decompensated HCV-related cirrhosis was established, patients showed not only a very high frequency of readmissions, but also developed decompensations different from the initial one. These results contribute to defining the natural course and prognosis of decompensated HCV-related cirrhosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ascites / etiology
  • Bacterial Infections / etiology
  • Carcinoma, Hepatocellular / etiology
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Hepatic Encephalopathy / etiology
  • Hepatitis C, Chronic / complications*
  • Humans
  • Hypertension, Portal / etiology
  • Liver Cirrhosis / etiology*
  • Liver Cirrhosis / mortality
  • Liver Neoplasms / etiology
  • Male
  • Middle Aged
  • Prognosis
  • Survival Rate