People with advanced fibrosis or cirrhosis of the liver typically see their liver damage improve after receiving a cure for hepatitis C virus (HCV), aidsmap reports. However, for a small subset of such individuals, liver damage remains steady or even worsens post-cure.
Publishing their findings in the Journal of Viral Hepatitis, Swedish researchers conducted a cross-sectional study of 269 people with hep C who had advanced fibrosis or cirrhosis before starting successful interferon-based treatment for the virus. No one in the study had liver cancer or HIV.
Forty-four percent of the participants had cirrhosis and the remainder had advanced cirrhosis. Fifty-nine percent were male. The median age when the study members were cured of hep C was 53. They were followed for a median 7.7 years after finishing treatment.
For the assessment of liver damage, the study relied on the FibroScan method, in which a score of 9.5 kilopascals or higher indicates advanced fibrosis and a score of 12.5 kPa or higher indicates cirrhosis.
Upon starting treatment for hep C, the study population’s median FibroScan score was 13.9 kPa, a figure that fell to 6.5 kPa by the end of follow-up, including a respective 8.5 kPa and 6.6 kPa among those who had cirrhosis and advanced fibrosis before beginning treatment.
Eighty-seven percent of those with pretreatment advanced fibrosis and 83 percent of those with pretreatment cirrhosis saw their liver damage improve posttreatment. Among those with pretreatment cirrhosis, 48 percent of those with less than five years of follow-up still had advanced fibrosis or worse liver damage by the end of the study period, compared with 21 percent of those followed for a decade or more.
Seventeen percent of those with pretreatment advanced fibrosis and 13 percent of those with pre-treatment cirrhosis did not see their liver damage improve during follow-up. Five percent of the overall study group experienced worsening liver damage after being cured of hep C.
Twenty-four percent of the participants had advanced fibrosis or worse liver damage at the end of the study period; about three quarters of this overall group had cirrhosis prior to receiving treatment for HCV.
The study authors estimated that having pretreatment cirrhosis, compared with having pre-treatment advanced fibrosis, was associated with a 3.9-fold greater likelihood of having advanced fibrosis or worse liver damage at the end of follow-up. In addition, being 55 or older when receiving hep C treatment, compared with being younger, and having a body mass index over 25 (indicating obesity), compared with having a lower BMI, were each associated with a 2.3-fold greater likelihood of having advanced fibrosis at the end of the study.
To read the aidsmap article, click here.