Robert Hindes, MD, completed a fellowship in infectious diseases at Harvard Medical School, and received board certification in infectious diseases in 1986. As the chief medical officer at BeyondWest Pharmaceuticals, Robert Hindes, MD, works on new treatments for hepatitis C infection, with a focus on developing countries.
More than three quarters of patients who contract the hepatitis C virus (HCV) will go on to develop a chronic infection. Those who do develop a chronic infection are at a high risk for serious health complications.
The progression to cirrhosis and liver cancer is often associated with few clinical symptoms, and some patients are only diagnosed with hepatitis C after they present with the complications of end-stage liver disease or hepatic cell cancer (HCC). Individuals with decompensated cirrhosis often have ascites, upper gastrointestinal bleeding caused by varices from portal hypertension, hepatorenal syndrome and hepatic encephalopathy. In the U.S., deaths in individuals with chronic HCV are more likely to be caused by complications from decompensated cirrhosis than from HCC. The probability of an episode of clinical decompensation is approximately 5% 1 year from the diagnosis of cirrhosis, and increases to 30% at 10 years. The 5-year survival rate following a diagnosis of decompensated cirrhosis is about 50%. In addition to causing end-stage cirrhosis, chronic HCV infection is a major cause of HCC. Unlike complications of end-stage liver disease, HCC often occurs in individuals with earlier stages of cirrhosis, and may occasionally occur before cirrhosis develops.
Early diagnosis of HCV is key in preventing these serious, lifelong infections, but this is difficult because most infected individuals do not develop symptoms. For this reason, screening should be performed in anyone with abnormal liver enzymes.