Let’s start with a fact about hepatitis C treatment. When it works (which is most of the time), hepatitis C antiviral therapy eliminates the virus. This means that people with the virus don’t have hepatitis C any longer. However, successful treatment does not guarantee anything beyond that. If you have cirrhosis you may continue to have cirrhosis and all of its signs and symptoms. You may develop liver cancer, lose kidney function, need a liver transplant, or die from liver failure. Being cured from hepatitis C doesn’t cure everything.

This is news to many who were not well-prepared about the realities of hepatitis C treatment. However, to the majority of those who were cured of hepatitis C, life changed dramatically. Cirrhosis was averted, liver cancer risk dropped, and all the other nasty potential consequences that hepatitis C may cause quietly slipped away. Personally, I could breathe a sigh of relief.

That relief was shattered while browsing through the latest research from the 2017 Liver Meeting sponsored by the American Association for the Study of Liver Diseases. Titled, Increase In Hepatocellular Carcinoma in Hepatitis C Patients Without Cirrhosis, the study examined the prevalence and trends in HCV-related hepatocellular carcinoma (liver cancer) from 2000 to 2015.

Sanath K.Allampati and colleagues analyzed electronic medical record data obtained from 2,328 subjects diagnosed with HCC; 20% of the subjects did not have cirrhosis at presentation. They found that liver cancer rates were trending consistently higher. Further, this increase was more pronounced in the non-cirrhotic group, increasing from under 10% to nearly 22%.

The researchers were concerned that with the advent of new hepatitis C treatments, there might be a large number of HCV-cured patients who could potentially develop hepatocellular carcinoma even though they do not have cirrhosis.

The Bottom Line: If your hepatitis C was treated and cured, talk to your doctor about follow-up tests. The HCV Guidelines recommend hepatocellular carcinoma surveillance for everyone with fibrosis stage 3 or 4. Personally, I am not sure that is generous enough, and perhaps people with earlier stages need following. 

Hepatitis C treatment is an incredible opportunity, but not if you don’t continue to take care of your health.