Delaying treatment for persons chronically infected with hepatitis C virus (HCV) regardless of fibrosis stage may be detrimental, a recent study suggests, given the increased risk of mortality even for those with moderate disease and the inability to predict the transition from mild to moderate disease. In this cohort study, transient elastography was performed on 964 persons chronically infected with HCV and with a history of injection drug use. Liver stiffness was evaluated semiannually from 2006 to 2014 using validated cutoffs from moderate fibrosis and severe fibrosis/cirrhosis. Researchers found:
- Among the study population, 62%, 23%, and 15% had baseline measurements suggestive of no/mild fibrosis, moderate fibrosis, and severe fibrosis/cirrhosis, respectively.
- All-cause and non-accidental mortality were elevated in persons with moderate fibrosis (aHRs, 1.42, 1.66, respectively) after adjustments.
- The transition from mild to moderate fibrosis could not be sufficiently predicted.
Cepeda JA, Thomas DL, Astemborski J, Sulkowski MS, Kirk GD, Mehta. Increased mortality among persons with chronic hepatitis C with moderate or severe liver disease: A cohort study. [Published online ahead of print March 10, 2017]. Clin Infect Dis. doi:10.1093/cid/cix207.