Risk factors for hepatocellular carcinoma in Hepatitis C patients with sustained virologic response to interferon therapy.
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.
Iwasaki
Yoshiaki
Y
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. yiwasaki@cc.okayama-u.ac.jp
Takaguchi
Kouichi
K
Ikeda
Hiroshi
H
Makino
Yasuhiro
Y
Araki
Yasuyuki
Y
Ando
Masaharu
M
Kobashi
Haruhiko
H
Kobatake
Toshitsugu
T
Tanaka
Ryoji
R
Tomita
Minoru
M
Senoh
Tomonori
T
Kawaguchi
Mitsuhiko
M
Shimoe
Toshinari
T
Manabe
Koji
K
Kita
Keiji
K
Shimamura
Junnosuke
J
Sakaguchi
Kohsaku
K
Shiratori
Yasushi
Y
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
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins