The number of hepatitis C patients suffering from advanced liver damage may be grossly underestimated and underdiagnosed, according to a new study.
Hepatitis C is a viral infection that causes inflammation and infection of the liver.
The findings, result of a study of nearly 10,000 patients suffering from hepatitis C, can have a significant effect on patient care and healthcare policy regarding the chronic disease.
"Knowledge of the prevalence of liver damage will help decision making regarding screening for the effects of hepatitis C, when to start anti-viral therapy and the need for follow-up counseling," explained Stuart Gordon, lead researcher and director of Hepatology at Henry Ford Hospital.
The research was led by researchers at Henry Ford Health System and the US Centers for Disease Control and Prevention.
The results suggest cirrhosis may be underdiagnosed in a large segment of the population.
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"Our results suggest a fourfold higher prevalence of cirrhosis than is indicated by biopsy alone," Gordon added.
The researchers discovered highly likely signs of liver damage by calculating the patients' liver enzymes, platelet counts and age in a previously validated test called a FIB-4 score.
A lot of patients in the study had cirrhosis and probably didn't know they had cirrhosis.
"Sometimes the clues of liver damage or cirrhosis are very subtle - a dropping platelet count, a spleen size that is slightly increased on an ultrasound," Gordon noted.
It is not unusual for patients with hepatitis C to come in and they have liver cancer, and they didn't even know that they had cirrhosis that led to their cancer.
The results could have wide impact on the treatment of those with hepatitis C, a disease now curable in many cases with oral antivirals.
"People with hepatitis C need to find out the severity of their underlying liver disease, because they may not realise that they have cirrhosis," the authors noted.