When one analyzes the medical records of 1.6 American adults, it turns out there’s a lot to be learned there. Researchers with the Chronic Hepatitis Cohort Study (CHeCS) did just that starting back in 2006 and tracked the ongoing health of those with hepatitis for the next numerous years. As the CHeCS researchers uncovered connections and new understandings about this population, they have published a variety of illuminating scientific papers.
Most recently, the CHeCS researchers shared an important discovery: the hepatitis C virus (HCV) causes greater liver damage earlier in the disease process than previously believed. Consequently, delaying treatment for HCV infection is now known to present a greater danger to long-term health and recovery.
The data in the current study revealed a higher than expected amount of HCV patients who had advanced liver damage. Specifically, 29% of HCV patients showed evidence of liver damage (namely cirrhosis). However, 62% of those with cirrhosis did not have documentation of this liver damage in their medical record. This means that most HCV patients with cirrhosis did not actually know about it, nor did their doctors.
Learning that liver damage is more prevalent than formerly known could change the decision making process for health care providers in terms of the timing of starting anti-viral treatment, as well as affect public policy related to accessing the new medications that can cure this disease.
What accounts for liver damage in HCV being underestimated and underdiagnosed? Health care providers generally rely on a liver biopsy to determine the presence or absence of cirrhosis. However, there are other diagnostic tests and biomarkers, which can provide a reliable indication of liver damage, such as liver enzymes, platelet counts, and Fibrosis-4 (FIB-4) score.
Moving forward, health care providers should incorporate these additional ways to uncover liver damage then use that knowledge to make more-informed decisions about the timing of starting HCV treatment.
Stephen C. Vogt, Pharm.D.
President and CEO
BioPlus Specialty Pharmacy
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Gordon SC, Lamerato LE, Rupp LB, et al. Prevalence of cirrhosis in hepatitis C patients in the Chronic Hepatitis Cohort Study (CHeCS): A retrospective and prospective observational study.
Am J Gastroenterol 2015;110(8):1169-77.