Brief Article
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World J Gastroenterol. Dec 7, 2011; 17(45): 5007-5013
Published online Dec 7, 2011. doi: 10.3748/wjg.v17.i45.5007
Increased fibrosis progression rates in hepatitis C patients carrying the prothrombin G20210A mutation
Nitsan Maharshak, Philippe Halfon, Varda Deutsch, Hava Peretz, Shlomo Berliner, Sigal Fishman, Shira Zelber-Sagi, Uri Rozovski, Moshe Leshno, Ran Oren
Nitsan Maharshak, Sigal Fishman, Shira Zelber-Sagi, Moshe Leshno, Ran Oren, Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, 64239 Tel Aviv, Israel
Philippe Halfon, Department of Virology, Laboratoire Alphabio, 23 Rue de Friedland, Hôpital Ambroise Paré, 13006 Marseille, France
Varda Deutsch, Uri Rozovski, The Hematology Institute, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, 64239 Tel Aviv, Israel
Hava Peretz, Clinical Biochemistry Laboratory, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, 64239 Tel Aviv, Israel
Shlomo Berliner, Internal Medicine “E”, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, 64239 Tel Aviv, Israel
Shira Zelber-Sagi, School of Public Health, University of Haifa, Mount Carmel, 31905 Haifa, Israel
Author contributions: Berliner S and Oren R devised the study concept; Maharshak N, Halfon P, Deutsch V, Peretz H, Berliner S, Fishman S, Zelber-Sagi S, Rozovski U, Leshno M and Oren R designed the study; Maharshak N, Halfon P, Deutsch V, Peretz H, Fishman S, Zelber-Sagi S, Rozovski U, Oren R- acquired the data; Maharshak N, Zelber-Sagi S, Rozovski U, Leshno M and Oren R analyzed and interpreted the data; Maharshak N wrote the manuscript.
Correspondence to: Nitsan Maharshak, MD, Department of Gastroenterology and Liver diseases, Tel Aviv Sourasky Medical Center, affiliated to the Sackler School of Medicine, Tel Aviv University, 6 Weizmann St, 64239 Tel Aviv, Israel. nitsan_maharshak@walla.com
Telephone: +972-3-6974282 Fax: +972-3-6974622
Received: January 10, 2011
Revised: April 10, 2011
Accepted: April 17, 2011
Published online: December 7, 2011
Abstract

AIM: To examine whether hepatitis C virus (HCV)-infected patients who carry hypercoagulable mutations suffer from increased rates of liver fibrosis.

METHODS: We analyzed DNA samples of 168 HCV patients for three common hypercoagulable gene mutations: prothrombin 20210 (PT20210), factor V Leiden (FV Leiden) and methylene tetrahydrofolate reductase (MTHFR). The patients were consecutively recruited as part of the prospective “Fibroscore Study” in France. The effect of the various mutations on the rate of fibrosis was analyzed statistically and was correlated with epidemiological, clinical and biochemical data such as grade and stage of liver biopsies, patients’ risk factors for liver cirrhosis, and timing of infection.

RESULTS: Fifty two of the patients were categorized as “fast fibrosers” and 116 as “slow fibrosers”; 13% of the “fast fibrosers” carried the PT20210 mutation as compared with 5.5% of the “slow fibrosers”, with an odds ratio of 4.76 (P = 0.033; 95% CI: 1.13-19.99) for “fast” liver fibrosis. Carriage of MTHFR or FV Leiden mutations was not associated with enhanced liver fibrosis.

CONCLUSION: Carriage of the PT20210 mutation is related to an increased rate of liver fibrosis in HCV patients.

Keywords: Hepatitis C virus; Liver fibrosis; Hypercoagulation; Prothrombin 20210