Alcohol
Alcohol significantly speeds up the rate of fibrosis. Research has clearly shown that the severity of liver disease in those with hepatitis C is much higher among those who consume alcohol. This has been seen in rates of fibrosis, development of cirrhosis, incidence of liver cancer and finally survival rates. A study reveals conclusively that a daily alcohol intake of more than 40 or 50 grams (4-5 units) significantly affects progression. Whether it is safe to consume any alcohol is uncertain so doctors tend to advise people with hepatitis C to abstain from alcohol entirely.
Age
People over 40 are progressively more susceptible to faster rates of fibrosis. Age is thought to be a significant factor due to the decrease in blood flow within the liver that occurs for everyone with age (so the liver is not operating at its optimum level), lower levels of immunity and a decrease in the ability to make full use of antioxidants. This is true whether you are initially infected with hepatitis C over the age of forty or if you have already had the disease for some time before you reach forty.
Gender
Men are more likely to have faster progression to cirrhosis than women whatever their age. It is thought that this is because oestrogen blocks some aspects of fibrosis development. For women the scarring progression can speed up after the menopause when oestrogen production decreases.
Lack of anti-oxidants
Normally, the liver is well equipped with a range of anti-oxidants. These are chemicals that can protect the liver from the damaging effect of oxygen free-radicals, the by-products and waste of many cellular and metabolic processes. However, in chronic liver disease, there seems to be a significant depletion of anti-oxidants. This is important because a surplus of oxygen free-radicals can create a condition known as oxidative stress, which has been associated with the progression of fibrosis.
Co-infection with HIV and Hepatitis B
HIV-HCV co-infection causes not only faster progression of liver damage but also can in some case speed up the progression to AIDS. Some research in USA showed that co-infection of HIV and HCV genotype 1a causes a faster progression to AIDS.
HCV and HBV co-infection can also cause a higher possibility of developing liver cancer.
Fatty liver
Fat accumulates in the liver if it is unable to metabolize it properly due to liver damage or excessive intake of fat through diet. This is called steatosis. This accumulation of fat can cause inflammation, which in turn may lead to more scarring. For more detailed information on steatosis click here
