Can Liver Damage Reverse After Hep C Treatment?

by Nirah Johnson Patient Expert

A slow and silent disease, the hepatitis C (hep C) virus is transmitted through exposure to infected blood. Left untreated, the virus can cause inflammation, fibrosis and then cirrhosis of the liver. This means that over a period of time, the virus can wreak havoc on your liver, causing long-term damage that is often thought to be irreversible. But new research suggests that if stresses to the liver stop, liver damage can reverse enough to improve health.

The consequences of cirrhosis

Liver fibrosis is caused by the natural wound-healing response to repeated injury to the liver. Injury can be caused by stressors like heavy alcohol use, or a viral infection like hepatitis C. When the liver is injured, scar tissue develops (fibrosis). If fibrosis continues to develop in the liver, nodules (knots of tissue) form. Finally, the liver shrinks, becomes stiff and stops working properly (cirrhosis). In most people with hep C, fibrosis develops slowly and increases over time, and cirrhosis takes 15 – 20 years to develop. There are two stages of cirrhosis: compensated cirrhosis in which the liver still functions, and decompensated cirrhosis in which the liver shuts down. Life threatening risks of cirrhosis include ascites, renal failure, hepatic encephalopathy, variceal bleeding, and liver cancer.

Hope for healing

Though the risks of cirrhosis are serious, the liver is an amazing organ, with a unique ability to heal (replace scar tissue with healthy tissue) in some cases. If you can stop the stress to the liver that is causing the damage by reducing or ceasing alcohol consumption or treating infections, liver damage can reverse or regress, and the liver has a chance to heal itself.

Recent studies have confirmed that if you have fibrosis - or even cirrhosis - and are treated and cured of hep C, the development of fibrosis will stop, and fibrosis will reverse in the majority of patients. Liver damage reversal is possible even when cirrhosis has developed. A recent review of multiple studies found that 53 percent of patients who were cured of hep C had regression of cirrhosis.

In another large US study looking at 4,731 Hep C patient’s fibrosis scores over a ten -year period, 1,657 (35 percent) were treated and 755 (46 percent) achieved a cure. The fibrosis scores of people who were cured decreased (indicating fibrosis regression), and remained significantly lower over the ten-year study period than in untreated patients or patients who were treated but not cured. Further, this study found that fibrosis scores continued to increase in people who were not treated, or who were treated but not cured.

Why and how to seek treatment

Hep C can now be cured in as little as eight weeks with all oral medications with few side effects. The majority of hep C patients are clinically eligible for treatment, regardless of treatment history, severity of liver disease, or other mental or physical health conditions that may have been treatment barriers in the past. Now is the time to get treated and cured to begin your liver’s healing process. Knowing that liver fibrosis and cirrhosis can reverse enough to improve your health if you are cured of hep C can be a powerful motivator to get into care and treatment. There are many hep C patients who have not seriously considered treatment with the new improved hep C meds, because they feel fine, had bad experience with older hep C treatments, or have been found to have very slowly progressing disease. Based on the study findings described above, it is important to note that not only does treatment and cure stop liver disease from progressing, but can also result in reversing existing damage. It’s not often that patients have this chance for renewed healthIf you have been thinking about getting hep C treatment, see the American Liver Foundation national site locator to find treatment near you.

Nirah Johnson
Meet Our Writer
Nirah Johnson

Nirah Johnson, LCSW, Director of Program Implementation & Capacity Building NYC Health Department, Viral Hepatitis Program serves as the lead organizer of the NYC Hep B Coalition and Hep C Task Force since 2007.