Studies stating increased mortality from hepatic and extrahepatic disease caused by chronic Hep C Infection

On 14 June last year, the European Haemophilia Consortium (EHC) held a Round Table of Stakeholders on ‘Hepatitis C.’

Two very important and timely topics were highlighted:

1. The increased risk of death from hepatic and extrahepatic diseases caused by chronic HCV infection; and
2. Scientific validation that Hepatitis C viral infection increases the risk of heart disease and stroke

This is external professional scientific validation of what many in the infected blood community have been pressing for recognition of.

This will be very important in the forthcoming Clinical Review the Scottish Government will carry out into extrahepatic impacts on those suffering from HCV infection.

Chronic Hepatitis C Virus Infection Increases Mortality From Hepatic and Extrahepatic Diseases: A Community-Based Long-Term Prospective Study

As published in the October 2013 edition of The Journal of Infectious Diseases, American researchers found that the reappearance of Hepatitis C RNA years after an SVR (sustained viral response) can be from relapse of the initial viral infection rather than re-infection from a different virus.

According to one of the study’s authors, Theo Heller, MD, chief of the translational hepatology unit at the Liver Diseases Branch of the National Institute of Diabetes & Digestive & Kidney Diseases at the NIH, “In a few people, Hepatitis C has found a sanctuary site and can remain dormant for a length of time. This is important both biologically and clinically, even in the approaching era of direct-acting antivirals, where relapse may still be a problem. We already know it can and does occur.”

Hepatitis C Virus Infection and Increased Risk of Cerebrovascular Disease

This article was published way back in November of 2010 when at that time they stated the association between hepatitis C virus (HCV) infection and cerebrovascular disease remained controversial.

The study aimed to assess the risk of lethal cerebrovascular diseases associated with chronic HCV infection and the authors concluded that there is indeed a link, in their words “Chronic HCV infection is an independent risk predictor of cerebrovascular deaths showing a biological gradient of cerebrovascular mortality with increasing serum HCV RNA level”.

Does Hepatitis C Virus Infection Increase Risk for Stroke? A Population-Based Cohort Study

Further Taiwanese research from February 2012 concurs with these findings. The research was published in The Public Library of Science (PLOS), a U.S. nonprofit organization that states it wants to accelerating progress in science and medicine by transforming research communication.

The authors state that the relationship between hepatitis C virus infection and risk of stroke remains inconsistent (two years worth of discussion moved this on from being controversial to being inconsistent).

The authors initially framed their argument that although chronic HCV infection was considered an independent risk predictor of cerebrovascular mortality, whether HCV infection increases the incidental event of stroke was undetermined. To clarify the potential impact of HCV infection on stroke, they conducted a population-based cohort study using reimbursement claims from Taiwan’s National Health Insurance Research Database with a follow-up period of 4 to 7 years.

This study evaluated the risk of stroke in association with chronic hepatitis C infection and concluded that yes, again there was a distinct link, in their words “Chronic hepatitis C infection increases stroke risk and should be considered an important and independent risk factor”.

Is your blood still infectious after being cured of Hepatitis C?

The author of this article at ‘Hepatitis Central’ pens her words in the context of at-risk populations being involved in at-risk behaviours, and not necessarily for those linked to infection acquired from contaminated blood or blood products provided by the state.

Their introduction says “Those lucky enough to be cured of Hepatitis C have much to celebrate, but remain unsure of what being cured actually means. Does ‘cured’ of Hepatitis C mean that all viral particles are 100 percent absent forever, or does it mean the virus has gone into remission? More importantly, does being cured completely eliminate all chances of infecting others in the case of blood-to-blood contact?”

A speaker at the EHC, Professor Rui Tato Marinho, suggested that if a SVR was maintained for three months it was safe to assume that the patient was cured in the vast majority of cases.

Continuing on the Hepatitis Central article above, after giving some useful information, the author concluded “Careful evaluation of information available shows that the medical community is torn on declaring SVR to be an absolute cure that renders the person no longer infectious”.

New medications and studies are making these sometimes controversial topics very fluid and we’ll provide updates when we receive them. We feel the information illustrated above is particularly relevant to those who’ve lost loved ones where their death certificates do not link the Hepaititic C virus to their death.

If you have any comments,  questions or indeed updates yourself, we’d be happy to hear from you.