Changes in the Prevalence of Hepatitis C Virus Infection, Nonalcoholic Steatohepatitis, and Alcoholic Liver Disease Among Patients With Cirrhosis or Liver Failure on the Waitlist for Liver Transplantation
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Summary
This summary is machine-generated.The burden of chronic hepatitis C virus (HCV) infection is decreasing among liver transplant candidates. However, nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are increasingly common indications for liver transplantation.
Area Of Science
- Hepatology
- Transplantation Medicine
- Epidemiology
Background
- Hepatitis C virus (HCV) infection treatments have improved, yet nonalcoholic fatty liver disease (NAFLD) incidence is rising.
- Liver transplantation improves survival for patients with acute hepatitis linked to alcoholic liver disease (ALD).
- Changes in liver disease burden in the US were assessed by comparing population prevalence data with liver transplant waitlist data.
Purpose Of The Study
- To evaluate the changing burden of liver disease in the United States.
- To compare the prevalence of liver diseases in the general population with their representation on liver transplant waitlists.
Main Methods
- HCV prevalence data were obtained from the National Health and Nutrition Examination Survey (2010, 2013-2014).
- Data on cirrhosis, chronic liver failure (CLF), and liver transplant recipients were analyzed from HealthCore and the United Network for Organ Sharing (UNOS) databases (2003-2015).
- Trends in waitlist and transplant indications were modeled using Spearman rank correlation, nonparametric tests, and linear regression.
Main Results
- The proportion of patients with positive HCV RNA decreased from 2010 to 2013-2014.
- Significant shifts in cirrhosis and CLF causes were observed, with decreases in HCV/ALD and increases in nonalcoholic steatohepatitis (NASH).
- Liver transplant waitlist data showed a decrease in HCV as an indication for CLF, alongside increases in NAFLD and ALD; HCC indications remained stable across etiologies.
Conclusions
- The proportion of patients on liver transplant waitlists or undergoing transplantation for chronic HCV infection is declining.
- Nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are increasingly common indications for liver transplantation.
- Despite shifts in population disease burden, NAFLD and ALD represent a growing proportion of liver transplant cases.