Mangoud Amal M, Eissa Mostafa H, Sabee Essam I, Ibrahem Ibrahem A, Ismail Alaa, Morsy Tosson A, Etewa Samia, Mahrous Seham, Nor Edin Essam, Mostafa Yousry, Abouel-Magd Yousry, Afefy Afefy F, el-Shorbagy Eman, el-Sedawy Mahmoud, Ragab Hosenia, Hassan Mostafa I, Lakouz Khalid, Abdel-Aziz Khalid, Saber Mahmoud, el-Hady Gaber
Faculty of Medicine, Zagazig University, Zagazig, Egypt.
J Egypt Soc Parasitol. 2004 Apr;34(1 Suppl):447-58.
The natural history of hepatitis C virus (HCV) infection has a highly variable course. Many patients develop chronic infection, with its consequent risk of cirrhosis, liver failure and hepatocellular carcinoma. A key question is whether patients at high risk of disease progression can be distinguished from those with relatively benign disease course. The disease progression is influenced by other factors such as duration of infection, age at infection, sex, co-infection with hepatitis B virus (HBV), Epstein Bar virus (EBV), cytomegalovirus (CMV), the level of HCV viraemia and its type. Other endemic infections in the community as bilharziasis may have a role in progression of the condition to serious complications. These factors are correlated with newly proposed grades and stages of the disease. The studied (109) cases were divided into 6 groups according to the concomitant infection with HCV. The result proved that groups 1, 3 & 5 had a higher level of viraemia than other groups, and to be the high-risk groups as 56.4% and 34.6% were in G2S2 and G3S3, respectively. All cases of liver cell dysplasia and hepatocellular carcinoma in this study were seen in these groups. The conclusion showed that these factors play an important role in the progression of HCV infection. Death of the patients of this progressive condition occurs in younger age and is more due to liver failure than to HCC.
丙型肝炎病毒（HCV）感染的自然病程具有高度可变的过程。许多患者会发展为慢性感染，并随之面临肝硬化、肝衰竭和肝细胞癌的风险。一个关键问题是，能否将疾病进展高危患者与病程相对良性的患者区分开来。疾病进展受其他因素影响，如感染持续时间、感染时的年龄、性别、与乙型肝炎病毒（HBV）、爱泼斯坦-巴尔病毒（EBV）、巨细胞病毒（CMV）的合并感染、HCV病毒血症水平及其类型。社区中的其他地方性感染如血吸虫病可能在病情进展为严重并发症方面起作用。这些因素与新提出的疾病分级和分期相关。根据HCV合并感染情况，将所研究的109例病例分为6组。结果证明，第1、3和5组的病毒血症水平高于其他组，且为高危组，分别有56.4%和34.6%的患者处于G2S2和G3S3阶段。本研究中所有肝细胞发育异常和肝细胞癌病例均见于这些组。结论表明，这些因素在HCV感染进展中起重要作用。这种进行性疾病患者的死亡发生在较年轻的年龄，更多是由于肝衰竭而非肝癌。
