Hepatitis C Treatment and Liver Cancer

Because I have been helping people get Hepatitis C treatment for 10 years now I often get emails from people I helped many years ago who want information about the long term effects of having Hepatitis C and how treatment affects outcomes such as liver cancer. The fact is that people who have had Hepatitis C and been successfully treated are more likely to get liver cancer than people how have never had Hepatitis C. But they are less likely to get liver cancer than people who have an active Hepatitis C infection. Here is one example of a person who did Hep C treatment ten years ago and has recently been diagnosed with liver cancer.

From: Rand
Sent: Tuesday, June 18, 2024 5:44:23 PM
To: greg jefferys <gregjefferys@outlook.com>
Subject: Re: Hepatitis C Treatment

Hi Greg

trust you have been well. I reach out to you again after almost 10 years.  Have you had experience of or feedback from any patients recovered from Hep C with AFP (Alpha Feto Protein) values > 50,000 ?

Hi Rand

To be honest I have never seen AFP levels above 50,000.

AFP is usually considered a tumour or cancer marker.

Further testing is recommended.
I would suggest an ultrasound scan of the liver would be the first thing to do

Best wishes

Greg

From: Rand
Sent: Wednesday, June 19, 2024 10:19:58 AM
To: greg jefferys <gregjefferys@outlook.com>
Subject: Re: Hepatitis C Treatment

Hi Greg,

Tumor/ Cancer has been diagnosed. But my question was that have you come across cases where Hep C patients who have been cured  , later on developed tumors? It’s an academic question.

Thanks

Rand

Sent from my iPhone

Hi Rand

Anyone who has had hep C is more likely to have problems with tumours or liver cancer.

It goes like this.

If a person has hep C they are more likely to get liver cancer than a person who has not had Hep C.

If a person is cured of Hep C they are less likely to get liver cancer than a person who still has Hep C but more likely to get liver cancer than a person who has never had Hep C.

A person who has had Hep C for a long time is more likely to get  liver cancer than a person who has had Hep C for a short time.

Its all related to liver damage.

The higher the level of liver damage done during the Hep C infection the more likely a patient is to get liver cancer.

Once the Hep C is cleared the liver begins to heal so the chance of getting liver cancer begins to decline.

Best wishes

Greg

So Why is a Person who has Cured Their Hep C at Higher Risk of Getting Liver Cancer?

A person who has been cured of Hepatitis C is more likely to get liver cancer than a person who has never had Hepatitis C due to several factors related to the virus’s impact on the liver over time. Here are the main reasons:

1. Liver Damage and Cirrhosis: Chronic Hepatitis C infection causes long-term inflammation of the liver, leading to liver damage. Over time, this can progress to fibrosis (scarring of the liver tissue) and eventually to cirrhosis, a severe form of liver scarring. Cirrhosis significantly increases the risk of liver cancer (hepatocellular carcinoma, HCC).
2. Persistent Cellular Changes: Even after the virus is cleared, the cellular and genetic damage caused by the chronic infection can persist. This includes mutations and changes in the liver cells that can lead to cancerous growths or tumours.
3. Duration of Infection: The risk of liver cancer is higher in individuals who have had Hepatitis C for a long period before getting cured. The longer the liver is exposed to the virus, the greater the extent of damage and the higher the risk of developing cancer.
4. Residual Fibrosis: While direct-acting antiviral (DAA) treatments can cure Hepatitis C, they do not necessarily reverse all the liver damage that has occurred. Residual fibrosis or cirrhosis remains a significant risk factor for liver cancer.

In summary, the increased risk of liver cancer in individuals cured of Hepatitis C is primarily due to the lasting impact of the virus on the liver, including chronic inflammation, fibrosis, cirrhosis, and persistent cellular damage. Even after successful treatment, these factors can continue to predispose the liver to cancerous changes.

What Can You Do to reduce the chance of developing Liver Cancer?

A person who has had Hepatitis C can do a number of things to reduce their chance of developing liver cancer, even after being cured of the virus. Here are some key strategies:

1. Regular Medical Follow-ups:
   • Surveillance: Regular follow-up with a healthcare provider for liver cancer screening is crucial. This often includes periodic imaging tests (like ultrasound, CT scans, or MRI) and blood tests (such as AFP ( alpha-fetoprotein) levels) to monitor for early signs of liver cancer.
   • Monitoring Liver Health: Regular liver function tests to monitor the liver’s condition and assess any ongoing liver damage or complications.
2. Lifestyle Modifications:
   • Avoid Alcohol: Abstaining from alcohol is important as alcohol can exacerbate liver damage and increase the risk of liver cancer.
   • Healthy Diet: Adopting a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall liver health. Avoiding excessive consumption of fatty, fried, or sugary foods can help prevent additional liver strain.
   • Maintain a Healthy Weight: Obesity and fatty liver disease (non-alcoholic fatty liver disease, NAFLD) can increase the risk of liver cancer. Maintaining a healthy weight through diet and exercise can mitigate this risk.
   • Vitamin D levels are important for liver health. Vitamin D from having your skin exposed to direct sunlight is the best source of vitamin D. Other natural sources of vitamin D are from oily fish like mackerel and salmon. Also certain mushrooms and other fungi.
3. Vaccinations and Infections:
   • Hepatitis Vaccination: Getting vaccinated against Hepatitis A and B can prevent further liver damage caused by these infections.
   • Avoid Risky Behaviours: Avoiding behaviours that could lead to re-infection with Hepatitis C or other blood-borne infections, through sharing needles or other drug administering equipment..
4. Regular Physical Activity:
   • • Exercise: Regular physical activity can help maintain a healthy weight, improve immune function, and reduce inflammation, all of which are beneficial for liver health. Regular exercise, particularly muscle building exercises, can stimulate organ regeneration.
     • By taking these proactive measures, people who have had Hepatitis C can significantly reduce their risk of developing liver cancer and maintain better overall liver health.

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