Prevalence of hepatocellular carcinoma in patients with alcoholic cirrhosis and prior exposure to hepatitis C.
Sixty-three patients with alcoholic cirrhosis were retrospectively studied for the prevalence of antibodies to core (P22) and nonstructural (C100) region of hepatitis C virus (HCV). The prevalence rate of anti-P22 antibodies in patients with alcoholic cirrhosis was higher than that of anti-C100 antibodies (63.5% vs. 54.9%). The positivity rate of anti-C100 and/or anti-P22 antibodies was 73.0% (46/63) in alcoholic cirrhosis. We performed a multivariate analysis on the effects of age, sex, cumulative alcohol intake, anti-HCV antibodies, indocyanine green excretion test, and serum albumin on the development of hepatocellular carcinoma HCC in patients with cirrhosis, using Cox's proportional-hazards model, which revealed that anti-HCV positivity was the only independent prognostic variable for HCC in patients with alcoholic cirrhosis. The probability of HCC was significantly higher in the anti-HCV-positive patients than in the negative patients with alcoholic cirrhosis (p < 0.05). The 3-, 5- and 10-yr cumulative occurrence rate of HCC was, respectively, 13.3%, 41.3%, and 80.7% for anti-HCV-positive patients with alcoholic cirrhosis, compared with 0%, 8.3%, and 18.5% for anti-HCV-negative patients. In nonalcoholic patients with type C cirrhosis, the 3-, 5-, and 10-yr cumulative occurrence rate of HCC was 7.3%, 23.1%, and 56.5%, respectively. The follow-up studies indicate that hepatocarcinogenesis is hastened significantly in patients with alcoholic cirrhosis if they are positive for anti-HCV antibody, and that heavy alcohol consumption also is a risk factor for the development of HCC in patients with type C cirrhosis.
Yamauchi
M
M
First Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
Nakahara
M
M
Maezawa
Y
Y
Satoh
S
S
Nishikawa
F
F
Ohata
M
M
Mizuhara
Y
Y
Hirakawa
J
J
Nakajima
H
H
Fujisawa
K
K
D000328:Adult; D000368:Aged; D000956:Antigens, Viral; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests; D014758:Viral Core Proteins / Q000276:immunology; D017361:Viral Nonstructural Proteins; D014764:Viral Proteins / Q000276:immunology
D000956:Antigens, Viral; C064544:C100 protein, hepatitis C virus; D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens; D014758:Viral Core Proteins; D017361:Viral Nonstructural Proteins; D014764:Viral Proteins; C499352:core protein p22, Hepatitis C virus; C069130:nucleocapsid protein, Hepatitis C virus