title: Hepatic steatosis is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis C virus infection.
abstract: BACKGROUND
  Hepatic steatosis is one of the histopathologic features of chronic hepatitis C. It was reported recently that the expression of hepatitis C virus (HCV) core protein in transgenic mice induced hepatocellular carcinoma (HCC) in association with steatosis. The objective of this study was to determine the relation between hepatic steatosis and hepatocarcinogenesis in patients with chronic HCV infection.
  
  
  METHODS
  The authors studied 161 patients with chronic HCV infection who were diagnosed at Nagasaki University Hospital, Nagasaki, Japan, between January 1980 and December 1999. Age, gender, body mass index (BMI), habitual drinking, diabetes mellitus, serum alanine aminotransferase (ALT) level, HCV serotype, serum level of HCV core protein, interferon (IFN) treatment, hepatic fibrosis inflammation, and hepatic steatosis were studied with regard to their significance in the development of HCC using univariate and multivariate analyses.
  
  
  RESULTS
  The cumulative incidence rates of HCC were 24%, 51%, and 63% at 5 years, 10 years, and 15 years, respectively. Multivariate analysis identified hepatic steatosis, together with aging, cirrhosis, and no IFN treatment, as independent and significant risk factors for HCC (P = 0.0135, P = 0.0390, P = 0.0068, and P = 0.0142, respectively). In addition, hepatic steatosis was correlated with BMI, serum ALT levels, and triglyceride levels.
  
  
  CONCLUSIONS
  The findings of the current study indicate that hepatic steatosis is a risk factor for HCC in patients with chronic HCV infection. Patients with chronic HCV and hepatic steatosis should be monitored carefully for HCC.
authors.affiliation: The First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ohata
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hamasaki
authors.forename: Kan
authors.initials: K
authors.lastname: Toriyama
authors.forename: Kojiro
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Akira
authors.initials: A
authors.lastname: Saeki
authors.forename: Kenji
authors.initials: K
authors.lastname: Yanagi
authors.forename: Seigou
authors.initials: S
authors.lastname: Abiru
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Masaya
authors.initials: M
authors.lastname: Shigeno
authors.forename: Seiji
authors.initials: S
authors.lastname: Miyazoe
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors