Clinical characteristics of patients with chronic hepatitis c infection at initial presentation to tertiary care in an Asian middle-income country

Chronic hepatitis C virus (HCV) infection is often asymptomatic until an occurrence of severe liver disease. A descriptive cross-sectional study was conducted of a hospital-based case-series in 2014 on 741 consecutive HCV patients presented at the national referral center in Malaysia, a middle-income Southeast Asian country. Mean age at initial presentation was 48 years (SD =11.5; median = 49) with 541 (73%) males. Prior known exposure to HCV risk factors were intravenous drug use (n = 271/737) and blood product transfusion (n = 237/737). HCV-genotype distributions were G3 (37.1%), G1 (21.4%), G2 (0.3%), G4 (0.1%) and G6 (0.1%), with 41.0% untested. Cirrhosis and non-cirrhotic chronic infection was present in 44 [mean (SD) age = 52 (9) years and 56% (mean (SD) age = 44 (12) years] patients, respectively. Of the 327 cirrhotic patients, 36% and 14% had decompensated cirrhosis and hepatocellular carcinoma respectively. Eighty percent patients were eligible for interferon treatment based on their stage of liver disease, but only 50% of the eligible patients received the treatment. Thus, HCV-infected patients at initial presentation to a tertiary care center in Malaysia reflected delayed presentation with a disproportionately high number of patients with liver cirrhotic. Improving access to clinical care and optimizing treatment with direct acting antiviral drug is essential to reduce the country’s burden of hepatitis C.