- Spanish researchers monitored the health of more than 1,000 people with hepatitis C
- After being cured of hepatitis C, survival rates were similar among people with and without HIV
- The most common causes of death were not related to liver health
Hepatitis C virus (HCV) infects the liver and causes inflammation in this vital organ. Although some people can spontaneously recover, in many people HCV causes chronic infection.
HCV triggers ongoing inflammation in the liver. Over time, this inflammation causes healthy liver cells to be replaced with scar tissue. As scar tissue in the liver accumulates, complications eventually develop, such as internal bleeding, fluid buildup in the abdomen and serious abdominal infections. Eventually, difficulty thinking clearly and problems with memory occur. Gradually, as the liver becomes increasingly unable to filter the blood of waste products, the skin turns yellow (jaundice). The risk of liver cancer increases as the amount of scar tissue increases. If left undiagnosed and untreated, HCV can result in death.
HCV can be diagnosed with a simple blood test. Treatment for this virus is generally safe, can be taken once daily and cures around 95% of people.
Although hepatitis C can be cured, there are still many people with chronic infection who do not get timely diagnosis and treatment. As a result, they develop advanced liver disease. It is therefore important to study the impact of HCV treatment in people with advanced liver disease.
Spanish researchers designed a study of more than 1,100 patients who had either hepatitis C or both HIV and HCV. Researchers concluded that HCV treatment is equally effective in people with advanced liver disease, whether or not they also have HIV.
Study details
Researchers studied 1,118 people living with hepatitis C across Spain. Sixty-one percent of participants were co-infected with HIV and HCV. All people with HIV/HCV co-infection received HIV treatment. On average, participants were in the study for six years.
The average profile of participants upon study entry was as follows:
- most participants were assigned male at birth—86% of people with coinfection and 72% of people with HCV alone
- most participants were in their 50s
- the proportions of people who had severe scarring of their liver (cirrhosis) were similar regardless of HIV status
Results
After being cured of HCV, the proportions of people who died were as follows:
- people with HCV alone – 10%
- people with HIV/HCV coinfection – 11%
Statistical analysis found that having HIV/HCV co-infection did not increase the risk of death once people had been cured.
The most common causes of death were not related to liver health and included the following issues:
- cancer (affecting organ-systems other than the liver)
- severe infections
- cardiovascular complications
For the future
The present study’s findings are encouraging. However, they underscore the need for interventions to monitor and improve the health of people who have recovered from HCV infection, including the following:
- reducing the risk of cardiovascular disease
- minimizing risk factors for cancer
- monitoring for cancer
The average length of time participants spent in the present study was six years. Funding for longer studies is needed to ensure that issues that emerge over time can be identified and addressed.
—Matthew Rodriguez
Resources
Hepatitis C Basics – CATIE
Integration of hepatitis C testing and treatment in OAT clinics – CATIE News
Increased risk of death in Canadian study of people who fall out of care for HIV and hepatitis C – CATIE News
‘One-stop’ health service in England achieves high rates of hepatitis C cure – CATIE News
REFERENCE:
Martín-Carmona J, Corma-Gómez A, Téllez F, et al. Clinical Infectious Diseases. 2024; in press.