analysis followed by stepwise logistic regression analysis. Cirrhosis is a frequent and severe event in the course of Among the patients enrolled, 21.4% had biopsy-proven cirrhochronic hepatitis C, but it is unclear why some patients desis. Prevalence of cirrhosis markedly varied according to the velop cirrhosis after a given period whereas others do not.
route of transmission of HCV. It was significantly more fre-We studied a large cohort of patients with chronic hepatitis quent in blood recipients (23.4%) than in drug users (7.0%). C to determine the role of the route of transmission of hepati-Although the occurrence of cirrhosis was dependent on distis C virus (HCV) in the onset of cirrhosis. Six thousand six ease duration, it remained more frequent in blood recipients hundred sixty-four patients were enrolled in a nationwide than in drug users for a given duration. Apart from the route survey of chronic hepatitis C in France. We first randomly of transmission, excessive alcohol intake was also associated defined a representative sample of 30 hospitals with medical with a higher risk of cirrhosis (34.9% vs. 18.2%; P õ .001), units managing patients with HCV infection. All patients with and so was HBV infection (24.6% vs. 21.1%; P õ .05). These chronic hepatitis C were enrolled if hepatitis C was diagnosed factors acted independently of the route of transmission. Heor treated in these units in 1991, 1992, or 1993. A questionpatocellular carcinoma was observed in 3.6% of all patients naire was filled in from the patients' charts and covered demoand in 17.8% of cirrhotic patients, and its occurrence was graphic data, risk factors for HCV infection, clinical and hisstrongly and mainly related to the presence of cirrhosis. In tological data, hepatitis B virus (HBV) and human conclusion, cirrhosis occurred in about 20% of the HCV-inimmunodeficiency virus status, and alcohol intake. Descripfected patients in this study and was more frequent in blood tive statistics were prepared, and factors potentially related recipients than in drug users, independently of disease durato the onset of cirrhosis were identified by means of univariate tion. Expected changes in the epidemiology of HCV infection might modify the risk of developing cirrhosis and, thereafter, cancer. (HEPATOLOGY 1997;26:485-490.) Abbreviations: HCV, hepatitis C virus; IVDU, intravenous drug user; CH, chronic hepatitis; HBV, hepatitis B virus; HBsAg, hepatitis B surface antigen; HIV, human immunodeficiency virus; HCC, hepatocellular carcinoma. From the 1 De ´partement de Sante ´Publique, 2 De ´partement d'He ´patologie et Gas-Hepatitis C virus (HCV) is responsible for a large number troente ´rologie, and 3 De ´partement de Bacte ´riologie et Virologie, Ho ˆpital Henri Mondor, of chronic liver diseases worldwide. The prevalence of HCV