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Threefold Increase in Cirrhosis Risk with HCV

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Individuals with hepatitis C infection are three times more likely to develop cirrhosis than are those who are hepatitis C negative, and fibrosis progression is pronounced within the first 5 years after infection, a retrospective cohort study has found.

Analysis of 10-year follow-up data from 1,840 individuals in a national database of hepatitis C (HCV) infected veterans, and 1,840 uninfected controls, found 18.4% of HCV+ individuals developed cirrhosis, compared with 6.1% of uninfected individuals, and they had a significantly higher rate of hepatic decompensation events (1.79% vs. 0.33%).

Increasing age, white race, hypertension, anemia, and a history of alcohol abuse were associated with a higher risk of cirrhosis among HCV+ individuals, but baseline or recent history of alcohol abuse or dependence did not significantly impact risk, according to a paper published online in JAMA Internal Medicine (2015;175:178-85 [doi:10.1001/jamainternmed.2014.6502]).

“Our study shows that fibrosis progression after HCV infection starts early and that a substantial proportion of HCV-infected persons develop significant fibrosis or cirrhosis within the first 5-10 years of infection [but] on the other hand, progression of cirrhosis to hepatic decompensation is uncommon in the first 9 years after cirrhosis,” wrote Dr. Adeel A. Butt of the University of Pittsburgh, and colleagues.

The National Institutes of Health and the VA Pittsburgh Healthcare System supported the study. Two authors declared receiving grants and fees from private industry.

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