Follow up physician visits and tests after being cured from Hepatitis C treatment can be life saving. Risk factors can still remain even after Hepatitis C is cured. Learn what risk factors you have and discuss a proactive follow up plan with your liver specialist.

Risk for Fatty Liver Disease

Astounding evidence found that almost half of Hepatitis C patients who have completed treatment with direct-acting antivirals and received the cure for Hep C are reported to show signs of Fatty Liver Disease in a recent study group.

“Fatty liver is very common now that hepatitis C is being treated effectively,” said Mazen Noureddin, MD, from Cedars-Sinai Medical Center in Los Angeles. Steatosis was “very prevalent” in the study population, “although liver enzymes were normal,” Dr Noureddin reported at The Liver Meeting in 2017. Steatosis is described as fat accumulation in the liver cells.

Dr. Noureddin, stated that monitoring patients after they have received a sustained virologic response (cure) is not a common practice but findings suggest long-term monitoring is warranted. “It should be made clear that we are not suggesting that DAAs lead to steatosis,” said Dr Noureddin. “Rather we think it is probably our cohort (study group of patients) and we need longer follow-up.”

“However, the study showed that even after achieving a cure for hepatitis C, approximately 50% of those patients demonstrated evidence of NAFLD, which may increase their risk for liver cirrhosis and liver cancer. ”

Reports from The Liver Meeting 2017: American Association for the Study of Liver Diseases (AASLD): Abstract 2155. Presented October 23, 2017.

Risk for Liver Cancer

Studies show Hepatitis C patients who have received the cure from treatment are still at risk for liver cancer.

Patients who have cirrhosis are at a higher risk of developing liver cancer. Other risk factors include patients who are 65 and older or patients with diabetes, or patients who previously had genotype 3.

Researchers from Houston VA Medical Center and Baylor College of Medicine (Houston, TX) presented data at the 2015 meeting of the American Association for the Study of Liver Diseases on the risk of developing HCC (Hepatocellular carcinoma) in patients with HCV (Hepatitis C Virus) who have achieved the cure from treatment.

Dr. El-Serag, the study’s principal investigator was asked to address the importance of this study, “We will be facing large numbers of cured HCV patients and this study gives us a glimpse what the clinical course might be. It is clear that while cure considerably reduces HCC risk in general, it does not eliminate it especially when cirrhosis is present and in those who get cured at an older age. Therefore, the sooner we cure patients the better off we are. Furthermore continued vigilance and HCC surveillance is warranted after cure in these subgroups.”

What Do Patients Need to Do

  • Schedule regular visits, bloods tests and exams with your liver specialist for follow up care.
  • Ultrasound and other tests are recommended every 6 months to a year depending on your risk factors.
  • Don’t drink alcohol of any type.
  • Don’t smoke and avoid exposure to harmful chemicals.
  • Eat a healthy diet and eliminate processed foods. If you have been diagnosed with cirrhosis or diabetes, make sure to consult with your physician on the correct balance that’s right for your condition.
  • Incorporate activity and exercise in your weekly schedule.
  • Seek a support group that relates to your condition and build friendships.
  • Be Proactive and keep positive rather than dwelling on what you can’t do, focus on what you can do. Strive to have a daily attitude of gratitude and appreciation. You will find taking daily steps toward taking better care of yourself improves your health and can have positive effects on your immune system.

This entry was originally published on Life Beyond Hepatitis C on July 14, 2021 and is reprinted with permission.