Long-term benefit of estrogen exposure.


Hepatology. 2004 Nov 24;40(6):1426-1433
Progression of liver fibrosis in women infected with hepatitis C:
Long-term
benefit of estrogen exposure.

Martino VD, Lebray P, Myers RP, Pannier E, Paradis V, Charlotte F,
Moussalli J, Thabut D, Buffet C, Poynard T.

Service d'Hepato-Gastroenterologie, GH Pitie-Salpetriere, Paris,
France.

Female sex is a protective factor for the progression of fibrosis in
patients with chronic hepatitis C virus (HCV) infection. Experimental
data
suggest that estrogens may have an antifibrotic effect.

The objective of
this study was to evaluate the influence of past pregnancies, oral
contraceptives, menopause, and hormone replacement therapy (HRT) on
liver
fibrosis progression in HCV-infected women.

Four hundred seventy-two HCV-infected women received a survey regarding
prior pregnancies, menopause, and the use of oral contraceptives and
HRT.
The impact of these variables on liver fibrosis and its progression
were
evaluated using multivariate analyses considering all putative
confounding
factors.

Two hundred one women completed the survey (43% response rate),
157 of whom had an estimated date of HCV infection (96 postmenopausal
women, 96 women with previous pregnancies, and 105 women with past use
of
oral contraceptives).

Through multivariate analyses, the estimated rate of fibrosis
progression
was higher in postmenopausal (P < .05) and nulliparous (P = .02) women
and
was associated with greater histological activity (P < .001). Prior use
of
oral contraceptives had no significant influence. Among postmenopausal
women, the estimated rate of fibrosis progression (+/-SE) was lower in
women who received HRT compared with untreated patients (0.099 +/-
0.016
vs. 0.133 +/- 0.006 METAVIR units/yr; P = .02) and was similar to that
of
premenopausal women (0.093 +/- 0.012 METAVIR units/yr; P value not
significant).

In conclusion, menopause appears to be associated with accelerated
liver
fibrosis progression in HCV-infected women, an effect that may be
prevented
by HRT. Pregnancies may have a beneficial impact on the long-term
progression of liver fibrosis. (HEPATOLOGY 2004;40:1426-1433.).

PMID: 15565616 [PubMed - as supplied by publisher]

Source URL-Online search at Pub med:
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Sandra Tara Balduf (Ane)

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