Reduction therapy of alanine aminotransferase levels prevent HCC development in patients with HCV-associated cirrhosis.
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
Rino
Yasushi
Y
Department of Surgery, Yokohama City University, School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. rino@med.yokohama-cu.ac.jp
Tarao
Kazuo
K
Morinaga
Souichiro
S
Ohkawa
Shinichi
S
Miyakawa
Kaoru
K
Hirokawa
Satoru
S
Masaki
Takahiro
T
Tarao
Norio
N
Yukawa
Norio
N
Saeki
Hiroyuki
H
Takanashi
Yoshinori
Y
Imada
Toshio
T
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
D004365:Drugs, Chinese Herbal; D011524:Protoporphyrins; C063587:juzentaihoto; C461320:shosaiko-to; D019695:Glycyrrhizic Acid; D014580:Ursodeoxycholic Acid; D000410:Alanine Transaminase