Prevalence and Challenges of Liver Diseases in Patients With Chronic Hepatitis C Virus Infection

Clinical Gastroenterology and Hepatology
Volume 8, Issue 11 , Pages 924-933, November 2010

Ira M. Jacobson, Gary L. Davis, Hashem El–Serag, Francesco Negro, Christian Trépo

published online 16 August 2010

Abstract

Hepatitis C virus (HCV) infections pose a growing challenge to health care systems. Although chronic HCV infection begins as an asymptomatic condition with few short-term effects, it can progress to cirrhosis, hepatic decompensation, hepatocellular carcinoma (HCC), and death. The rate of new HCV infections is decreasing, yet the number of infected people with complications of the disease is increasing. In the United States, people born between 1945 and 1964 (baby boomers) are developing more complications of infection. Men and African Americans have a higher prevalence of HCV infection. Progression of fibrosis can be accelerated by factors such as older age, duration of HCV infection, sex, and alcohol intake. Furthermore, insulin resistance can cause hepatic steatosis and is associated with fibrosis progression and inflammation. If more effective therapies are not adopted for HCV, more than 1 million patients could develop HCV-related cirrhosis, hepatic decompensation, or HCC by 2020, which will impact the US health care system. It is important to recognize the impact of HCV on liver disease progression and apply new therapeutic strategies.

Keywords: Hepatitis C Virus, Burden of Disease, Hepatic Comorbidities, Prevalence

Abbreviations used in this paper: AASLD, American Association for the Study of Liver Diseases, CHC, chronic hepatitis C, ECC, extrahepatic cholangiocarcinoma, HCC, hepatocellular carcinoma, HIV, human immunodeficiency virus, ICC, intrahepatic cholangiocarcinoma, IDU, injection drug use, IOM, Institute of Medicine, MeSH, Medical Subject Headings, NHANES, National Health and Nutrition Examination Survey, SVR, sustained virologic response

This article has an accompanying continuing medical education activity on page e117. Learning Objectives—At the end of this activity, the learner should be able to appreciate the prevalence of HCV virus infection in the United States as well as worldwide, understand the natural history of HCV infection, including the long-term risk of cirrhosis and hepatocellular cancer, and recognize that a sustained viral response represents a virologic cure.

Conflicts of Interest The authors disclose the following: Ira M Jacobson is a consultant for Abbott, Anadys, Boehringer Ingelheim, Bristol-Meyers Sqibb, Genetech, Gilead Sciences, GlobeImmune, Human Genome Sciences, Merck, Novartis, Pfizer, Pharmasset, Tibotec, Zymogenetics, and Vertex Pharmaceuticals (including advisory board for manuscript); an investigator for Abbott, Anadys, Boehringer Ingelheim, Genetech, Gilead Sciences, GlobeImmune, Human Genome Sciences, Idenix, Merck, Novartis, Pfizer, Pharmasset, Tibotec, Vertex Pharmaceuticals, and Zymogenetics; and a speaker for Bristol-Myers Squibb, Genetech, Gilead Sciences, Merck, and Novartis. Gary L. Davis is an investigator and consultant (including advisory board for manuscript) for Vertex Pharmaceuticals and receives research funding from Human Genome Science, Merck, Roche, Schering-Plough, and Vertex Pharmaceuticals. Hashem El-Serag is a consultant for Vertex Pharmaceuticals (including advisory board for manuscript). Francesco Negro is a consultant for Vertex Pharmaceuticals (including advisory board for manuscript) and receives educational grant support from Roche. Christian Trépo is an investigator and consultant for Vertex Pharmaceuticals (including advisory board for manuscript).

Funding This report is based on material identified by the authors during an advisory board meeting conducted by Vertex Pharmaceuticals Incorporated.

PII: S1542-3565(10)00780-9
doi:10.1016/j.cgh.2010.06.032
© 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.

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