Aspectos clínicos da hepatite C crônica: experiência do Ambulatório de Hepatites Virais/Instituto ALFA de Gastroenterologia/Hospital das Clínicas da UFMG

Este estudo retrospectivo investigou os aspectos clinicos de 295 pacientes com hepatite C cronica. A idade variou entre 13 e 81 anos (mediana=49 anos) sendo 55% entre 40 a 60 anos. O fator de risco principal foi hemotransfusao, seguido pelo uso de drogas injetaveis. A maioria dos casos era assintomatica. Cinquenta por cento dos pacientes apresentavam complicacoes da cirrose hepatica ao diagnostico. Nao houve associacao entre o genotipo e a gravidade da fibrose hepatica. Os fenomenos auto-imunes foram diagnosticados em 10% dos pacientes. A ALT estava aumentada em 69% dos casos. Trinta e dois por cento tinham ALT normal e 8% destes eram cirroticos. Somente 26% dos pacientes tratados com interferon mais ribavirina por 48 semanas apresentaram resposta virologica sustentada. Os resultados deste estudo alertam para a alta morbidade da hepatite C no nosso meio.(AU) Clinical aspects of chronic hepatitis C in a retrospective study including 295 patients were studied. The age ranged from 13 to 81 years (mean = 49 years); 55% were 40 to 60 years old. The mainly risk factor to infection was blood transfusion, followed by drug injection. Most patients were asymptomatic but 50% had cirrhosis by the time of diagnosis. Genotype was not related to worse status of fibrosis. Auto-immune events appeared in 10% of patients. High and normal levels of alanine-aminotransferase (ALT) were found in 69% and 32% of the patients, respectively. Eight per cent of the patients with normal levels of ALT were cirrhotic. Only 26% of treated patients had sustained response to virus after treatment with interferon and ribavirin for 48 weeks. The results show a high morbidity.(AU)