title: Risk factors for hepatocellular carcinoma in Hepatitis C patients with sustained virologic response to interferon therapy.
abstract: BACKGROUND
  Although a variety of papers demonstrated inhibited hepatocarcinogenesis with interferon (IFN) therapy for chronic hepatitis C, a small number of hepatocellular carcinomas (HCCs) were still observed even in sustained virologic responders.
  
  
  OBJECTIVE
  To clarify factors affecting the development of HCC, we analyzed the frequency of HCC in sustained virologic responders over a long-term observation period.
  
  
  METHODS
  Seven hundred and ninety-two out of the 2623 IFN-treated hepatitis C patients who had undergone liver biopsy showed sustained virologic response. Screening for development of HCC was performed periodically during an average follow-up of 5.1 years. Fibrosis of the pretreatment liver biopsy sample was graded. Risk factors for HCC were analyzed by using Cox proportional hazards regression.
  
  
  RESULTS
  Of 792 patients, 23 developed HCC. Univariate analysis showed that stage of hepatic fibrosis, age, and alcohol consumption were significantly associated with a risk of HCC (P<0.001). There was a significant difference in the cumulative incidence between patients stratified according to these variables (P<0.001).
  
  
  CONCLUSIONS
  Pretreatment hepatic fibrosis score, age, and alcohol consumption may affect development of HCC even in sustained virologic responders. Thus, patients with these factors should be carefully followed even after eradication of the virus.
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. yiwasaki@cc.okayama-u.ac.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Kouichi
authors.initials: K
authors.lastname: Takaguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ikeda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Makino
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Araki
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ando
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kobashi
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Kobatake
authors.forename: Ryoji
authors.initials: R
authors.lastname: Tanaka
authors.forename: Minoru
authors.initials: M
authors.lastname: Tomita
authors.forename: Tomonori
authors.initials: T
authors.lastname: Senoh
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Toshinari
authors.initials: T
authors.lastname: Shimoe
authors.forename: Koji
authors.initials: K
authors.lastname: Manabe
authors.forename: Keiji
authors.initials: K
authors.lastname: Kita
authors.forename: Junnosuke
authors.initials: J
authors.lastname: Shimamura
authors.forename: Kohsaku
authors.initials: K
authors.lastname: Sakaguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shiratori
mesh_terms: D000328:Adult; D017677:Age Distribution; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D019562:Viral Load
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins