A new study by researchers at Baylor College of Medicine found that treatment and cure of chronic hepatitis C reduce the risk of hepatocellular carcinoma (HCC), especially if given early, before cirrhosis develops, and while patients are still young. The report appears in the journal Hepatology.
Chronic hepatitis C is a common and progressive liver infection caused by the hepatitis C virus, a strong risk factor for HCC, the most common type of primary liver cancer.
“With the advent of new highly effective medications for treating hepatitis C, we expect to see a lot of people cured of the disease,” said Dr. Hashem El-Serag, chief of gastroenterology and hepatology at Baylor and at the Michael E. DeBakey Veterans Affairs Medical Center and lead author of the study. “However, we did not have good information about what happens to these people in terms of their future risks of developing HCC after cure.”
This large and definitive study involved 33,005 individuals infected with the hepatitis C virus who received treatment in Veterans Health Administration hospitals throughout the United States, and of whom 10,817 patients achieved cure. Researchers tracked their risk of developing HCC liver cancer over several years of follow-up and examined the association between several demographic and clinical features at the time of the cure with the future risk of liver cancer.
Researchers found that successful antiviral treatment for hepatitis C is associated with a significant reduction in risk of cirrhosis, HCC and overall mortality, regardless of age. Therefore, delaying treatment should not be advised. Patients with hepatitis C aged 65 to 85 years who received less antiviral treatment than younger patients were more likely to develop cirrhosis and liver cancer than patients with hepatitis C aged 20 to 49 years.
“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 El-Serag.
The time of cure is essential for determining prognosis. High emphasis should be given to increasing screening and diagnosis of hepatitis C before those infected develop cirrhosis, through assessment of degree of liver fibrosis, said El-Serag.
Others who took part in this study include Dr. Fasiha Kanwal, Peter Richardson, and Jennifer Kramer, all from Baylor College of Medicine.
Supported in part by National Institutes of Health (NIH) grant from the National Cancer Institute R01 116845, the Houston VA HSR&D Center of Innovations (CIN13-413), the Texas Digestive Disease Center NIH DK58338. Drs. El-Serag and White's effort is supported in part by the National Institute of Diabetes and Digestive and Kidney Diseases (K24-04-107 and K01 DK081736, respectively).