Background: Chronic viral hepatitis C (CHC) infection is a well-known cause of chronic liver disease and cirrhosis worldwide. In evaluation of the status of liver cirrhosis, liver biopsy remains the gold standard; however, it is associated with some rare but serious complications. Recently, non-invasive tests using vibration-controlled transient elastography (VCTE) have been increasingly used in clinical practice instead of liver biopsy.

Objectives: To describe the prevalence of liver cirrhosis identified by VCTE in Thai CHC patients and also to find the predictive factors of liver cirrhosis.

Materials and Methods: The data were retrospectively retrieved of consecutive CHC patients who underwent VCTE and Controlled Attenuation Parameter (CAP) at Rajavithi Hospital, Bangkok between 1 January 2015 and 31 December 2017. Clinical characteristics, CAP, VCTE, HCV genotype, HCV viral load and laboratory data were reviewed. Liver fibrosis status was described and predictors of liver cirrhosis were analyzed.

Results: A total of 216 patients were included, none of whom had received any antiviral therapy. Males accounted for 73.1% of subjects, whose mean age was 49.63+8.33 years. Obesity was found in 37.5% of patients (BMI >25 kg/m2) and hepatic steatosis, defined as CAP >248 (dB/m), was found in 34.7%. HCV genotype 3 was the most predominant subtype (50.9%), and cirrhosis defined as VCTE >12.5 kPa was found in 51.4%. Multivariate analysis revealed that AST level and platelet count were associated with cirrhosis with aOR of 1.02 (95% CI: 1.01 to 1.02) and 0.99 (95% CI: 0.98 to 0.99) respectively.

Conclusion: More than half of these Thai chronic hepatitis C patients had liver cirrhosis. The simple surrogate biomarkers of liver fibrosis, high AST level and low platelet count, are indicators of advanced liver disease. This positive finding should encourage further evaluation by either VCTE or liver biopsy to delineate the underlying liver fibrosis status of patients.

Keywords: Chronic viral hepatitis C, Fibrosis, Liver cirrhosis, Elasticity imaging techniques