Presentation Date: 02 APR, 2011
DOES SCREENING FOR HEPATITIS C RESULT IN EARLY DETECTION OF DISEASE AND OFFERS EARLY VIRAL ERADICATION?
M. Sharma1*, S.A. Kaabi1, N.A. Dweik1, A. John1, K. Matar1, M.A. Mohannadi1, M.F. Derbala1, R. Yacoub1, F. Pasic1, M.T. Butt1, R. Singh2
1Division of Gastroenterology, Department of Internal Medicine, 2Department of Medical Research, Hamad Medical Corporation, Doha, Qatar. *maniksharma29@yahoo.com
Background: Screening for Hepatitis C has not been found to be beneficial in healthy individuals.
Aim: To compare the disease pattern and response to treatment among two groups of patients with Hepatitis C. Group 1(Screening Group) comprised of patients detected from the screening survey and Group 2 (Referral Group) were patient referred for treatment from other centres in the same time period. Secondary aims included to compare the above differences in the average and the high risk population among the Group 1 patients.
Methodology: A Community based survey was done to screen for Hepatitis C antibodies in the average and high risk population over a 16 months period in the State of Qatar. Screening was done using a rapid immunochromatographic assay. All patients (Group1 and 2) detected to have at least grade 1 and stage 1 disease on the liver biopsy (as per Scheuer classification), were offered treatment with Pegylated Interferon and ribavirin. .
Results: 13704 people were screened and 272 people were detected to have positive antibodies (Group 1) and 237 patients were referred (Group 2) in the same time period.148 patients in the Group 1 (62 %) and 234 in the Group 2 (98%) consented for further evaluation. Both the groups were similar in age, sex, co-aggravating factors, mean viral load and genotype. ALT and AST were significantly lower in the Group 1 than the Group 2(p=.01). Liver histology revealed milder grade of necroinflammation (grade 0-2) and significantly lesser fibrosis (stage 0-2) in the group 1 (p= .00).The response to treatment (RVR/EVR) was significantly better in the Group 1 than in the Group 2 (72.4 % versus 54.5 %, p=.02).Table 1.Among the Group 1, only ALT was found to be significantly higher (p=.04) in the high risk group but histology and response to treatment was similar to the average risk group.
Click On Table 1 To Enlarge
Conclusion: Screening for hepatitis C results in detection of the disease with relatively preserved liver function tests, lesser fibrosis and necroinflammation and with a better response to the standard treatment.
http://www1.easl.eu/easl2011/program/Posters/Abstract1060.htm
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