Liver transplant waiting lists and liver transplantation are decreasingly driven by hepatitis C virus (HCV) and increasingly prompted by non-alcoholic steatohepatitis (NASH) and alcoholic liver disease (ALD), Healio reports.
Publishing their findings in the journal Gastroenterology, researchers collected data on the prevalence of hep C from the National Health and Nutrition Examination Survey (NHANES), looking at the 2010 and 2013 to 2014 cycles. They also collected data from the HealthCore Integrated Research Database on individuals with cirrhosis and chronic liver failure between 2006 and 2014. Additionally, they gathered data from the United Network for Organ Sharing (UNOS) on those on liver transplant lists as well as on liver transplantees from 2003 to 2015.
The 2013 to 2014 NHANES data show that 50 percent of those who had a positive HCV antibody test also had a positive HCV RNA test. In 2010, this proportion was 64 percent.
People who have been exposed to hep C will test positive for antibodies to the virus, but those who have cleared the virus, whether spontaneously (their immune systems do so within a few months of infection) or through treatment, will test negative for HCV RNA. The decrease in the proportion of NHANES respondents who tested positive to both tests likely indicates that a greater proportion of those infected with the virus are getting cured.
The data from the HealthCore database show that a decreasing proportion of those with compensated cirrhosis developed the condition because of HCV or ALD. Meanwhile, an increasing percentage of those with cirrhosis developed it because of NASH. A decreasing percentage of those with chronic liver failure had the condition due to HCV or ALD while the proportion of those with the condition due to NASH nearly tripled. Hepatocellular carcinoma (HCC, the most common form of liver cancer) was decreasingly caused by HCV or ALD while there was a small increase in the rate of HCC among those with NASH.
Examining the 2003 to 2015 UNOS data, the researchers found that among people new to the liver transplant waiting list or undergoing transplantation of the organ because of chronic liver failure, HCV was decreasingly a cause while NASH and ALD were increasingly causes. Among those new to the liver transplant list or undergoing transplantation of the organ because of HCC, the proportions of those with HCV, NASH and ALD did not change.
To read the Healio article, click here.
To read the study abstract, click here.