title: Hepatitis C virus infection in alcoholic liver cirrhosis in Japan: its contribution to the development of hepatocellular carcinoma.
abstract: To determine risk factors for hepatocellular carcinoma (HCC) in Japan, we studied 575 patients with liver cirrhosis (LC) who presented to our out-patient clinics in a month; 217 patients with habitual drinking with or without viral infections (AL-LC), 235 with hepatitis C virus (HCV) infection, 40 with hepatitis B virus (HB) infection, and 82 with liver diseases from other aetiologies such as primary biliary cirrhosis (PBC). HCC was found in 28% of AL-LC, 27% of HCV-LC, and 18% of HB-LC. HCV antibody examined by the second-generation HCV antibody assay (HCV II) was positive in 49% of AL-LC without HCC, and 84% of AL-LC with HCC. HCV was significantly associated with the development of HCC with an odds ratio of 1.90 by multivariate analysis, whereas alcohol alone did not become a risk factor, with an odds ratio of 0.65. When both variables were combined (HCV+AL), however, the odds ratio was increased twice to 3.65. One-hundred and thirteen patients who had a history of blood transfusion more than 10 years ago were selected to assess the interaction between alcohol and HCV in hepatocarcinogenesis. A year-adjusted disease occurrence rate calculated by the Kaplan-Meyer method showed that HCV+AL had a significantly higher disease occurrence rate than HCV alone. These results suggest that although alcohol alone may not become a risk factor for HCC, it may potentiate the development of HCC caused by HCV. HCV+AL is considered to be the highest risk group; strict abstinence is necessary for these patients.
authors.affiliation: Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyakawa
authors.forename: C
authors.initials: C
authors.lastname: Sato
authors.forename: N
authors.initials: N
authors.lastname: Izumi
authors.forename: J
authors.initials: J
authors.lastname: Tazawa
authors.forename: A
authors.initials: A
authors.lastname: Ebata
authors.forename: K
authors.initials: K
authors.lastname: Hattori
authors.forename: H
authors.initials: H
authors.lastname: Sakai
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: R
authors.initials: R
authors.lastname: Hirata
authors.forename: Y
authors.initials: Y
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors