Cirrhosis Increases 40% in Individuals Living With Hepatitis C

Mei Lu, Ph.D., presenting study results
Warren Tong

The prevalence of cirrhosis (liver disease) increased by almost 40% from 2006-2014, going from 20.5% to 28.8% among individuals living with hepatitis C (HCV) in the U.S., according to a study presented at the Liver Meeting 2016, in Boston. The greatest increase occurred prior to 2007, the study found.

The study, which was presented by Mei Lu, Ph.D., collected data from the Chronic Hepatitis Cohort Study (CHeCS), a longitudinal observational study on individuals living with hepatitis C from four large health systems in the U.S.

The researchers followed 11,169 U.S. adults living with hepatitis C between 2006 and 2014. About 24% were African American and 7% were Asian/Pacific Islander. The proportion of older individuals (over 60 years old) living with hepatitis C increased from 15% in 2006 to 49% in 2014.

Of note, the prevalence of cirrhosis among the study participants increased from 20.5% in 2006 to 24.8% in 2010 and on average was about 25% from 2007 to 2012. The prevalence of decompensated cirrhosis increased by about 10%, from 8.8% in 2006 to 9.8% in 2014, an increasing trend confined to older patients, the researchers found.

"The proportion of hepatitis C patients with cirrhosis and its complications has grown significantly in the past decade, particularly among those over 60," said lead author Stuart C. Gordon, M.D., according to the study press release.

The researchers also noted racial disparities among the cirrhosis rates, observing that African Americans and Asians/Pacific Islanders were significantly more likely to develop cirrhosis than white counterparts.

The incidence of all-cause mortality also increased among the study population, almost doubling from 1.7% in 2006 to 3.2% in 2013. Higher rates of mortality were observed in older patients, African Americans and men.

One limitation of the study was that it did not analyze the effect of treatment or sustained virologic response (SVR) on cirrhosis. It also did not include undiagnosed patients or those who were not regularly in care with one of the health systems.

"The present analysis confirms the rising burden of chronic hepatitis C infection, and its complications, on the U.S. health care system. These rising rates may have leveled off in recent years, however, possibly related to better options for treating HCV infection. Future studies will help determine whether increased uptake of these newer medications can help stem the tide of HCV disease progression," Gordon concluded.