Angiotensin Receptor Blockade as an Anti-Fibrotic Intervention in Patients With Chronic Hepatitis C

Hepatitis C is the most common reason for liver transplantation in the United States and
affects nearly 4 million Americans. Treatments for hepatitis C are available but are poorly
tolerated and are not always effective. Morbidity and mortality from hepatitis C are related
to the development and progression of hepatic fibrosis to cirrhosis and end stage liver
disease. Efforts to block progression of liver disease would thus result in prevention of
morbidity and mortality as well as costs incurred by the health system in the care of these
conditions.

Scar tissue in the liver is secreted by a type of cell, called the stellate cell, in an
activated state. This cell carries a receptor for angiotensin, a hormone, when activated. If
this receptor is blocked, the cell becomes inactive and does not participate in scar tissue
formation. Thus, we hypothesize that using a drug such as candesartan, which blocks
angiotensin receptors, should result in less scar tissue formation in the livers of patients
with hepatitis C.