An Infection with Hepatitis C May Eventually Lead to Liver Cancer

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Injection drug use is the single most common source of hepatitis C infection. Image by Optigan13

The hepatitis C virus causes a contagious liver disease by the same name, resulting in lifelong illness. Hepatitis C virus infection occurs when the blood from an infected person transfers to another person. 3–4 million hepatitis C virus infections occur annually; 150 million people worldwide have chronic hepatitis C infections and are at risk of developing liver cancer. At least 350,000 people die from hepatitis C-related liver disease each year.

Hepatitis C Disease

Hepatitis C incubates for up to 6 months, and at least 80% of infected people lack any symptoms. The few people who are acutely symptomatic present with fatigue, nausea,  joint pain and jaundice, which is a yellowing of the skin and eyes. A total of 85% of newly-infected persons develop chronic hepatitis, and 70% of chronically infected people develop chronic liver disease, including cirrhosis (5-20%). A total of 1–5% of people with chronic hepatitis C die from cirrhosis or liver cancer. In fact, the underlying cause of cancer in 25% of liver cancer patients is hepatitis C.

Hepatitis C Infection: Diagnosis

Doctors sometimes miss hepatitis C diagnoses because most people infected with the virus lack symptoms. The presence of antibodies against the hepatitis C virus indicates that a person is or was infected by the virus. The presence of antibodies to the hepatitis C virus in the blood for longer than 6 months is confirmation of the diagnosis. Specialized tests evaluate patients for liver disease, including cirrhosis and liver cancer.

One Patient’s Experience of Long-term Hepatitis C

An 88-year-old, otherwise healthy man, received a diagnosis of liver cancer in October 2012, and with hepatitis C in February 2013. As of March 2013, he has slow-growing liver cancer in one lobe. He never received a blood transfusion, has no pain, and exhibits no signs or symptoms of liver cancer. He represents the 10% of liver cancer cases with unknown etiology.

Janssen Pharmaceutica Outlines New Anti-Viral Treatments for Hepatitis C

Decoded Science asked Janssen Pharmaceutica if their new anti-viral treatments are effective for long-term hepatitis C sufferers: “As the number of available treatments for hepatitis C has increased, so has the chance of being cured. Changes in treatment over time have led to an increased chance of SVR.” A sustained virologic response (SRV) is a lack of virus in the blood 24 hours, called aviremia, after treatment with new antiviral agents.

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Treatment regimens for hepatitis C. Image by Janssen Pharmaceutica

Protease inhibitors, also known as Direct Acting Anti-Virals , help to prevent the hepatitis C virus from multiplying. They have been shown to increase the chance of a cure for all patients when taken in combination with pegylated interferon alfa and ribavirin versus pegylated interferon alfa and ribavirin alone.  Currently there are two available protease inhibitors: Boceprevir and Telaprevir.”

 Blood Transfusion Screening

Hospitals did not screen blood transfusions for hepatitis C prior to the 1970s, so blood transfusions prior to that era are a risk for long-term hepatitis C infection. The consequences of long-term infection with hepatitis C are now apparent, with elderly patients requiring nursing home care. Some countries make provisions for the lack of screening by paying for the nursing home care for those who are infected, but we do not know the true number of people infected with hepatitis C worldwide.

References

World Health Organization. Hepatitis C. (2012). Accessed March 15, 2013.

Stop Hep C. Case Studies. Janssen Pharmaceutica. Accessed March 15, 2013.

Hansen, P and Flora, K. FAQ: The link between hepatitis C and liver cancer. Providence Health & Services. Accessed March 15, 2013.

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