Hepatic fibrosis in hepatitis C

Abstract

Infection with the Hepatitis C virus (HCV) leads to liver inflammation and fibrosis, which progresses to cirrhosis. Cirrhosis leads to complications including hepatocellular carcinoma (HCC), end-stage liver disease, the necessity for liver transplantation, or death. In fact, HCV is the leading cause of liver transplantation, accounting for more than 40 % of liver transplants in the United States (Organ Procurement and Transplantation Network 2010). Because of the extended interval between infection and the emergence of complications, the proportion of HCV-infected patients with cirrhosis is expected to reach 45 % by 2030 (Davis et al. 2010). Fibrosis stage predicts morbidity, including liver-related deaths (Everhart et al. 2010). Patients with cirrhosis from HCV infection have an increased risk of developing HCC, estimated at 1-3 % per year (Fattovich et al. 1997), and the risk increases when comparing patients with cirrhosis relative to those with bridging fibrosis (Lok et al. 2009). With an estimated 180 million people infected by HCV worldwide, fibrosis and its progression to cirrhosis represent a major global problem (Rosen HR 2011).