Infection with Hepatitis C Increases Risk of Cirrhosis

People who are infected with the hepatitis C virus (HCV) have a higher risk for developing the liver disease cirrhosis, particularly within the first five years after infection. These findings were released in JAMA Internal Medicine.

Cirrhosis, or late-stage fibrosis, is a chronic liver disease characterized by the replacement of normal tissue with fibrous tissue and the loss of functional liver cells. It can result from alcohol abuse, nutritional deprivation, or infection—especially by the hepatitis virus. Chronic hepatitis C virus (HCV) infection affects about 150 million people around the world. This condition is a leading cause of cirrhosis and cancer of the liver.

It’s important to understand how frequently HCV progresses to liver fibrosis and cirrhosis. Knowing this risk can allow doctors and patients with HCV to make informed treatment decisions.

Researchers recently conducted a study to determine how frequently people with HCV developed liver fibrosis and cirrhosis and how frequently their liver stopped functioning. They tried to find factors associated with this progression.

The study used a database of veterans. Between 2002 and 2012, the researchers created two groups to evaluate: one with 1,840 people who had tested positive for HCV and another with 1,840 people who had tested negative for the virus. Members of each group were matched to compare incidence of liver fibrosis and failure.

The researchers found a total or 452 cases of cirrhosis and 85 cases of liver failure. People with HCV appeared three times more likely to develop cirrhosis within 10 years of follow-up: about 18% of those with HCV developed cirrhosis by this time compared with about 6% of those without HCV. Cirrhosis didn’t progress to liver failure in many participants, but occurred more frequently in people with HCV (almost 2% versus less than 1% in those without HCV).

Factors associated with a higher risk of cirrhosis in people with HCV included older age, White race, high blood pressure, anemia, and a history of alcohol abuse.

According to this study, fibrosis is more likely to progress quickly to cirrhosis in people who test positive for HCV. As well, fibrosis appears to progress quickly after infection with HCV. Fortunately for people with cirrhosis, liver failure is uncommon within nine years of developing cirrhosis.

Reference: Butt AA, Yan P, Lo Re V III, et al. Liver Fibrosis Progression in Hepatitis C Virus Infection After Seroconversion. JAMA Internal Medicine. February 2015 1;175(2):178-85.

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