Public Release:  Hepatitis C screening essential to help catch patients with advanced liver fibrosis

Research validates the current recommendation that screening for hepatitis C, particularly among high-risk groups, is vital

European Association for the Study of the Liver

April 25, 2015, Vienna, Austria: Study results presented today at The International Liver Congress™ 2015 show that the occurrence of advanced liver fibrosis is similar for patients infected with the hepatitis C virus (HCV), whether or not they have been diagnosed.

Most individuals with HCV remain asymptomatic, which makes the diagnosis difficult. The study authors used the hypothesis that individuals whose HCV is not diagnosed are less likely to have advanced fibrosis than those who have been diagnosed. They then compared liver fibrosis between respondents of the National Health and Nutrition Examination Survey (NHANES) in the USA, in patients with diagnosed and undiagnosed HCV infection.

Of the respondents with known HCV infection, the proportion with a high, intermediate and low probability of advanced fibrosis was 14.5%, 40.3%, 45.2%, respectively; in those with undiagnosed HCV the results were 19.1%, 30.9%, 50.0%, respectively.

The study highlights that even if people are unaware they are infected with HCV, the virus affects their liver in the same way, resulting in advanced fibrosis. These results validate the current recommendation that screening for HCV, particularly among high-risk groups, is vital.

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About The International Liver Congress™

This annual congress is the biggest event in the EASL calendar, attracting scientific and medical experts from around the world to learn about the latest in liver research. Specialists share research studies and findings, and discuss the hottest topics related to liver disease. This year, the congress is expected to attract approximately 10,000 delegates from all corners of the globe. 2015 is a very special year for EASL and the hepatology community as they will celebrate the 50th annual meeting. The International Liver Congress™ takes place from April 22-26, 2015, Vienna, Austria.

About EASL

Since EASL's foundation in 1966, this not-for-profit organisation has grown to over 4,000 members from more than 100 countries around the world. EASL is the leading liver association in Europe, it attracts the foremost hepatology experts and has an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.

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EU and Public Health: Hall C (Plenary) Presentation time: 11:30 - 11:45 Presenter: Prowpanga Udompap (United States) Abstract O120: ADVANCED FIBROSIS IS COMMON IN INDIVIDUALS WHOSE HEPATITIS C HAS NOT BEEN DIAGNOSED: RESULTS FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY 2001-2012

ADVANCED FIBROSIS IS COMMON IN INDIVIDUALS WHOSE HEPATITIS C HAS NOT BEEN DIAGNOSED: RESULTS FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY 2001-2012

Prowpanga Udompap* 1, Ajitha Mannalithara1, Nae-Yun Heo1, W. Ray Kim1 1Division of Gastroenterology and Hepatology, Stanford University, Stanford, United States

Background and Aims: Hepatitis C virus (HCV) infection is a global public health problem - while it is common, its consequences may be severe, including end stage liver disease and hepatocellular carcinoma. Moreover, most individuals with HCV remain asymptomatic, which makes the diagnosis difficult. With the hypothesis that individuals whose HCV is not diagnosed are less likely to have advanced fibrosis than those who have been diagnosed, we compare liver fibrosis between respondents to the National Health and Nutrition Examination Survey (NHANES) with diagnosed and undiagnosed HCV infection.

Methods: Testing for HCV was incorporated in NHANES 2001-2012. In a subgroup of the respondents with HCV infection, follow-up questionnaires were administered. Awareness of HCV infection was assessed by the question whether they had known they had HCV before receiving a letter from NHANES. Liver fibrosis was estimated by the FIB-4 and APRI scores. Based on the published cut-off values for advanced fibrosis, the proportion of respondents with a high probability of advanced fibrosis was compared between respondents with known and undiagnosed HCV.

Results: Out of 30,140 respondents of the NHANES survey, 360 tested positive for HCV RNA. There were 355 participants with complete laboratory data needed for the FIB-4 and APRI scores, of whom 130 had completed the full hepatitis C follow-up questionnaires. Slightly less than half (47.7%, n=62) knew that they had hepatitis C infection before the survey, whereas in the remainder (52.3%), HCV was only discovered from the survey. In the figure, the two groups were comparable with respect to age, sex, aminotransferase and platelet counts. BMI was higher in those with known diagnosed, the significance of which is uncertain. The raw FIB-4 and APRI scores were similar between the two groups. Among the respondents with known HCV infection, the proportion with a high, intermediate, and low probability of advanced fibrosis was 14.5%, 40.3%, 45.2%, respectively. The corresponding data in those with undiagnosed HCV were 19.1%, 30.9%, 50.0%, respectively. A similar pattern was seen with the APRI score.

Conclusions: While more than half of survey respondents did not know of their HCV infection, their liver fibrosis was no less advanced than those whose HCV had been diagnosed prior to participation in the survey. These data further justifies the current recommendation for HCV screening in asymptomatic individuals.

Disclosure of Interest: P. Udompap: : None Declared, A. Mannalithara: : None Declared, N.-Y. Heo: : None Declared, W. R. Kim: Consultant: Gilead, BMS

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