Cirrhosis Underreported in Hepatitis C Patients

Liver damage in patients with hepatitis C virus (HCV) may be more common than doctors previously thought, according to a study conducted by researchers at Henry Ford Health System and the Centers for Disease Control and Prevention.

In a study of nearly 10,000 patients suffering from HCV, 29% had evidence of liver damage or cirrhosis. However, 1727 of the 2788 patients with liver damage, or 60%, had no formal documentation in their medical records that they had cirrhosis.

The results of the study suggest that cirrhosis is largely underdiagnosed in patients with HCV, which may be due to the fact that many doctors rely on biopsy results for diagnosis. Among the HCV patients studied, only 661 patients were diagnosed through a liver biopsy.

The researchers assessed liver damage by using the patient’s liver enzymes, platelet counts, and age in a previously validated test called a Fibrosis-4 score. The clues of cirrhosis may be very subtle, according to Stuart Gordon, MD, lead researcher and director of hepatology at Henry Ford Hospital, and may include a drop in platelet count or a slightly increased spleen size on an ultrasound.

“It’s an underappreciated, easily obtained, and widely available test done through lab work that can point out there’s a problem,” said Dr. Gordon in a press release. “It’s a simple test not routinely used by clinicians. A lot of patients in our study had cirrhosis and probably didn’t know they had cirrhosis. In addition, electronic medical record reports may not be a reliable indicator of just how many hepatitis C patients may be suffering from cirrhosis.”

The results of the study could have a wide impact on the treatment of those with HCV and the diagnoses of cirrhosis in those patients. Although oral antivirals may cure the virus, these treatments are oftentimes too expensive for patients to obtain, which is why it is so important for patients to monitor the severity of their liver disease.