Development and progression of gastroesophageal varices in patients with chronic hepatitis C

Hepatitis C virus infection is the leading cause of chronic liver disease in the western world. Chronic liver diseases may cause, through portal hypertension, the development of gastroesophageal varices, which can then bleed. We assess the findings of a study aimed at identifying the incidence of de novo varix development and their progression in patients with chronic hepatitis C and advanced fibrosis. This study was a substudy of the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial. The HALT-C trial was designed to determine whether pegylated interferon (PEG-IFN) at low dose can reduce the rate of disease progression in these patients. Approximately 26% of patients developed de novo varices and 35.2% of patients with varices at baseline had variceal progression or bleeding during the 4-year follow-up. The authors examine demographic, clinical, laboratory, virological, endoscopic and histological factors associated with the development and progression of gastroesophageal varices. PEG-IFN-alpha 2a therapy did not reduce the risk of development or progression of gastroesophageal varices.