Natural history of decompensated hepatitis C virus-related cirrhosis. A study of 200 patients

Ramon Planas, Belén Ballesté, Marco Antonio Álvarez, Monica Rivera, Silvia Montoliu, Josep Anton Galeras, Justiniano Santos, Susanna Coll, Rosa Maria Morillas, Ricard Solà

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Background/Aims Since few data are available concerning the clinical course of decompensated hepatitis C virus (HCV)-related cirrhosis, the aim of the present study was to define the natural long-term course after the first hepatic decompensation. Methods Cohort of 200 consecutive patients with HCV-related cirrhosis, and without known hepatocellular carcinoma (HCC), hospitalized for the first hepatic decompensation. Results Ascites was the most frequent first decompensation (48%), followed by portal hypertensive gastrointestinal bleeding (PHGB) (32.5%), severe bacterial infection (BI) (14.5%) and hepatic encephalopathy (HE) (5%). During follow-up (34±2 months) there were 519 readmissions, HCC developed in 33 (16.5%) patients, and death occurred in 85 patients (42.5%). The probability of survival after diagnosis of decompensated cirrhosis was 81.8 and 50.8% at 1 and 5 years, respectively. HE and/or ascites as the first hepatic decompensation, baseline Child-Pugh score, age, and presence of more than one decompensation during follow-up were independently correlated with survival. Conclusions Once decompensated HCV-related cirrhosis was established, patients showed not only a very high frequency of readmissions, but also developed decompensations different from the initial one. These results contribute to defining the natural course and prognosis of decompensated HCV-related cirrhosis. © 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)823-830
JournalJournal of Hepatology
Issue number5
Publication statusPublished - 1 May 2004


  • Ascites
  • Bacterial infection
  • Hepatic encephalopathy
  • Hepatocellular carcinoma
  • Portal hypertensive gastrointestinal bleeding


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