Hepatitis C is a viral infection that leads to inflammation and infection of the liver. A new study by researchers at Henry Ford Health System and the US Centers for Disease Control and Prevention has suggested that the number of hepatitis C patients suffering from advanced liver damage may be grossly underestimated and underdiagnosed. The study suggest liver cirrhosis may be underdiagnosed in a large segment of the population. The findings can have a significant effect on patient care and healthcare policy regarding the chronic disease.
For the study, researchers analyzed nearly 10,000 patients suffering from hepatitis C. Stuart Gordon, lead researcher and director of Hepatology at Henry Ford Hospital, said, "Knowledge of the prevalence of liver damage will help decision making regarding screening for the effects of hepatitis C, when to start anti-viral therapy and the need for follow-up counseling. Our results suggest a fourfold higher prevalence of cirrhosis than is indicated by biopsy alone."
The research team discovered highly likely signs of liver damage by calculating the patients' liver enzymes, platelet counts and age in a previously validated test called a FIB-4 score. Several patients in the study had cirrhosis and probably did not know they had cirrhosis. Gordon said, "Sometimes the clues of liver damage or cirrhosis are very subtle - a dropping platelet count, a spleen size that is slightly increased on an ultrasound. It is not unusual for patients with hepatitis C to come in and they have liver cancer, and they didn't even know that they had cirrhosis that led to their cancer."
The results could have wider impact on the treatment of those with hepatitis C, a disease now curable in many cases with oral antivirals. The authors said, "People with hepatitis C need to find out the severity of their underlying liver disease, because they may not realize that they have cirrhosis."