Liver Damage From Hepatitis C Is More Common Than You Think

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Severe liver damage may be four times more common among Americans with the liver infection hepatitis C than previously believed, a new study suggests.

Analyzing nearly 9,800 patients with hepatitis C, researchers learned that using a biopsy alone to reveal liver cirrhosis — indicating scarring in the organ — is likely to seriously underestimate its prevalence.

The recent emergence of medications that can cure hepatitis C, a “silent killer” that often goes undetected until advanced disease sets in years later, adds weight to the new findings, doctors said.

“We thought it would be important to provide the health care community with some estimate as to the severity of liver disease among patients with hepatitis C because it’s a question that comes up very frequently: Just how sick is this community?” said study author Dr. Stuart Gordon, director of hepatology at Henry Ford Hospital in Detroit.

Hepatitis C is a viral infection that’s typically spread through contact with the blood of an infected person, and is estimated to kill 500,000 people worldwide each year, according to the World Health Organization. About 2.7 million Americans are thought to have chronic hepatitis C, which when untreated can lead to cirrhosis and liver failure or liver cancer, according to the U.S. Centers for Disease Control and Prevention.

For the study, Gordon and his team analyzed records from 9,783 hepatitis C patients cared for at four large U.S. health care systems. The records indicated that 29 percent of the patients had evidence of liver damage, or cirrhosis. But medical records didn’t indicate the cirrhosis in 62 percent of these patients, the study found.

Liver biopsy is considered the gold standard for diagnosing cirrhosis, but the researchers found a fourfold higher prevalence of cirrhosis among patients than shown by biopsy alone. Other clinical tests, including blood tests and a noninvasive scoring system known as the FIB-4 score, can also reveal cirrhosis but are underused, Gordon said.