Chronic hepatitis C that is treated and cured early — before cirrhosis develops and while patients are still young — reduces the risk of hepatocellular carcinoma (HCC), Baylor College of Medicine researchers reported in the study, “Risk of Hepatocellular Carcinoma After Sustained Virological Response in Veterans With Hepatitis C Virus Infection” published in the journal Hepatology.
Most people with the hepatitis C virus (HCV) develop chronic hepatitis C infection, an illness associated with increased liver disease.
“With the advent of new highly effective medications for treating hepatitis C, we expect to see a lot of people cured,” Dr. Hashem El-Serag, the study’s lead author, and chief of gastroenterology and hepatology at Baylor and at the Michael E. DeBakey Veterans Affairs Medical Center, said in a recent news release. “However, we did not have good information about what happens to these people in terms of their future risks of developing HCC after cure.”
Researchers conducted a retrospective cohort study using data from the Veterans Affairs VA hepatitis C virus (HCV) Clinical Case Registry. HCV treatment (interferon with or without ribavirin) and sustained virologic response (SVR, an RNA test negative at least 12 weeks after the end of treatment) were determined. They identified 33,005 HCV-infected individuals who received treatment, of whom 10,817 achieved a cure (SVR).
The risk of developing HCC — the most common type of liver cancer — was tracked over a follow-up period of several years, with researchers investigating the relationship between several demographic and clinical characteristics at the time of the cure, and how they associated with a future risk of liver cancer.
Results showed that a successful antiviral hepatitis C treatment was linked with a reduction in the risk of developing cirrhosis, HCC, and overall mortality, regardless of age, highlighting the importance of not delaying treatment.
Data also showed that patients with hepatitis C between the ages 65 and 85, who were treated with less antiviral therapy than younger patients, were more likely to develop cirrhosis and liver cancer compared to those ages 20 to 49.
“Patients with cirrhosis or diabetes or those who are older than 55 who get cured of hepatitis C need continued surveillance according to current guidelines,” said Dr. El-Serag. He added that the time of cure is fundamental to determining prognosis, and said special attention should be given to increased hepatitis C screening and diagnosis prior to patients developing cirrhosis, by evaluating the degree of liver fibrosis.
Chronic hepatitis C is estimated to affect 2.7 million to 3.9 million people in the United States, where it remains the major cause of cirrhosis, HCC, and liver transplantation.