Medical Health Encyclopedia

Because there are millions of Americans now infected with chronic hepatitis C, experts have been justifiably concerned that there will be a significant number of cases of liver failure and liver cancer in the coming years. Computer analyses have suggested that mortality rates from HCV-related cirrhosis or liver cancer will double or triple over the next twenty years. Fortunately, improved therapies may significantly reduce these discouraging estimates.

Risk Factors for Developing Cirrhosis from Hepatitis B. The great majority of people with chronic persistent hepatitis B have a good long-term outlook. Between 5% and 10%, however, become carriers of the virus and 5% to 10% of these individuals eventually develop cirrhosis. The addition of hepatitis D is a particular danger and increases the risk for cirrhosis. Seven genetic types of hepatitis B virus (designated A to G) have now been identified, which may help researchers determine which patients may have a better outlook than others. Genotype C is the most common and is more aggressive than genotype B, which also responds better to treatment.

Risk Factors for Cirrhosis in Autoimmune Liver Diseases

Primary biliary cirrhosis accounts for only 0.6% to 2% of deaths from cirrhosis. And in patients with chronic persistent autoimmune hepatitis, the outlook is very favorable and survival rates are equal to the general population. If it becomes active, it must treated, since untreated the five-year survival rates are 50%.

Obesity and Other Risk Factors for Cirrhosis

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A 2003 study of more than 11,000 patients, published in the journal Gastroenterology, revealed that obesity increased the risk of death from cirrhosis in those who drank little or no alcohol, but not in alcoholics. Previous evidence has suggested that severe obesity and diabetes are major risk factors for cirrhosis in nonalcoholic steatohepatitis (NASH) patients. (Severe obesity in any case is a risk factor for liver damage and in one study, 2.3% of patients with severe obesity had signs of cirrhosis.) Men are at higher risk than women and African Americans have a higher risk than Caucasians. Patients with NASH-associated cirrhosis generally do better than patients with alcohol-related liver damage, however.