title: Reduction therapy of alanine aminotransferase levels prevent HCC development in patients with HCV-associated cirrhosis.
abstract: BACKGROUND
  To find a way to prevent the development of hepatocellular carcinoma (HCC) from hepatitis C virus-associated liver cirrhosis (HCV-LC), an analysis of the HCV-LC patients who had received reduction therapy of the alanine aminotransferase (ALT) levels was performed.
  
  
  METHODS
  Seventy-four consecutive HCV-LC patients of Child Stage A were followed for >10 years for the development of HCC. They were divided into two groups: in group A, the reduction therapy for the ALT levels was aggressively performed, while in group B, the reduction therapy was not performed aggressively. The patients were subdivided into three sub-groups according to their serum ALT levels. In groups A and B, the high ALT group was comprised, respectively, of nine and five patients whose annual average serum ALT levels were persistently high (> or =80 IU), while the low ALT group was comprised of 19 and 20 patients whose annual average serum ALT levels were persistently low (<80 IU). The remaining eleven and ten patients had annual average serum ALT levels which fluctuated and were unclassified (unclassified group).
  
  
  RESULTS
  In group B, 65.7% of the patients had developed HCC in 13 years, in contrast to only 41.0% of group A (p=0.039). In group A, the median HCC development time was 12.8 years, in contrast to only 3.8 years in group B (p=0.0013). Multivariate analysis demonstrated that the mode of reduction therapy and ALT levels were the significant factors affecting HCC development.
  
  
  CONCLUSIONS
  The chances of surviving for more than ten years without developing HCC for HCV-LC patients
authors.affiliation: Department of Surgery, Yokohama City University, School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. rino@med.yokohama-cu.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Rino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tarao
authors.forename: Souichiro
authors.initials: S
authors.lastname: Morinaga
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ohkawa
authors.forename: Kaoru
authors.initials: K
authors.lastname: Miyakawa
authors.forename: Satoru
authors.initials: S
authors.lastname: Hirokawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Masaki
authors.forename: Norio
authors.initials: N
authors.lastname: Tarao
authors.forename: Norio
authors.initials: N
authors.lastname: Yukawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Saeki
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takanashi
authors.forename: Toshio
authors.initials: T
authors.lastname: Imada
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000201:enzymology / Q000517:prevention & control* / Q000821:virology; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D005260:Female; D019695:Glycyrrhizic Acid / Q000627:therapeutic use; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology* / Q000821:virology; D008113:Liver Neoplasms / Q000201:enzymology / Q000517:prevention & control* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011524:Protoporphyrins / Q000627:therapeutic use; D012189:Retrospective Studies; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D004365:Drugs, Chinese Herbal; D011524:Protoporphyrins; C063587:juzentaihoto; C461320:shosaiko-to; D019695:Glycyrrhizic Acid; D014580:Ursodeoxycholic Acid; D000410:Alanine Transaminase