Spotlight Series on Hepatitis C


Hepatitis C Research Snapshots

June 2016

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Survival of Patients With HCV Cirrhosis and Sustained Virologic Response Is Similar to the General Population

S Bruno et al. Journal of Hepatology 2016 vol. 64 j 1217-1223.

Study Aims and Results

The study looked at the overall survival of 181 patients with hepatitis C-related cirrhosis who were cured with interferon-based therapy. These patients were compared to hepatitis C patients who had decompensated cirrhosis, non-treated, and non-cured. The overall survival was calculated from the date at the start of interferon therapy to death.

The risk of death to the general population was also established by matching the results to the sex and age results of the general population.

Of the 181 people followed for a median of 9.6 years (range of 1-25 years) 28 people died. The 10-year survival was 91% and the 20-year survival was 63%. The number of expected deaths in the group of people (HCV cured group vs healthy group) matched by sex and age to the general population was the same -- 28 people.

There were a very small amount of people who were cured, but developed decompensated cirrhosis and liver cancer even after achieving a cure.

Editorial Comments


This is good news for people with hepatitis C. We need clinical studies with direct-acting antivirals to further understand the relationship between being cured and disease progression. This is even more important with direct-acting antiviral medications.

As mentioned above, there were some people who developed decompensated cirrhosis, liver cancer and died. It is critically important that people are followed after being cured.

Another study conducted by the Veteran's Administration found that at the beginning of treatment the following factors could influence the further disease progression even after being cured:

  • Cirrhosis
  • 64 years old
  • Genotype 3
  • Diabetes

It is important to know that the risk of these types of complications is low and the benefits of being cured are extremely high. Prevention and vigilance is the key to living well with hepatitis C even after being cured of it.

Role of Human Papillomavirus in Non-Oropharyngeal Head and Neck Cancers

JD Combes et al. Oral Oncol. 2014 May;50(5):370-9. doi: 10.1016/j.oraloncology.2013.11.004. Epub 2013 Dec 9.

Study Aims and Results

The MD Anderson Cancer Center was the first cancer center established to treat HCV-infected cancer patients. The center physicians started to notice a large number of patients with head and neck cancers among their patients. As a result they decided to study whether hepatitis C is associated with head and neck cancers.

The medical records at the center from 2004 through 2014 were analyzed for primary oropharyngeal or non-oropharyngeal. The control group (non-hepatitis C) had smoking-associated cancers -- lung, esophagus, or urinary bladder. The biopsy reports of the oropharyngeal cancers were tested for human papillomavirus (HPV) and reviewed. All of the patients with lymphoma were excluded.

A total of 34,545 cancer patients were tested for hepatitis C. Of those patients, 409 had head and neck cancers (164 oropharyngeal and 245 non-oropharyngeal). The number of patients with oropharyngeal cancer with hepatitis C antibodies was 14% compared to 6.5% of those without hepatitis C antibodies. This was even higher in HPV-positive oropharyngeal cancer -- 16.9% vs. 6.5% and still higher in the non-oropharyngeal group -- 20.0% vs. 6.5%.than in the control group.

The authors concluded that there needs to be further studies to understand the relationship between hepatitis C, HPV and other HPV-related cancers.

Editorial Comments

Hepatitis C is not just a liver disease. It is a systemic disease that affects every area of the body. The larger medical profession is finally catching up to what patients and some medical providers have known all along. More research is needed to understand the connection between hepatitis C and head and neck cancers.

There are well-known extrahepatic-manifestations that affect the mouth and salivary glands such as sialadenitis and Sjogren's Syndrome. There are many extrahepatic conditions. Want to learn more? Check out our Extrahepatic Manifestation Glossary.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). HPV is so common that nearly all sexually active men and women get it at some point in their lives. Some types of it can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems.

Lymphoma is a cancer that starts in the cells that are part of the body's immune system.

Oropharyngeal cancers are cancers that begin in and around the throat.

Non-oropharyngeal cancers are cancers that begin in and around the mouth.

An association is when two different attributes occur together either more or less often than expected by chance. In other words -- the association between oropharyngeal and non-orpharyngeal cancers doesn't mean the hepatitis C causes them it means that there is a higher rate of HCV in people who have these types of head and neck cancers.

This article was provided by HCV Advocate. Visit HCV Advocate's website to find out more about their activities and publications.

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