Hepatocarcinogenesis following HCV RNA eradication by interferon in chronic hepatitis patients.
OBJECTIVE
Interferon (IFN) therapy reduces the incidence of hepatocarcinogenesis in patients with hepatitis C viral (HCV) infection who achieve a sustained virological response (SVR). The aim of the present study was to determine the rate of hepatocarcinogenesis and the risk factor in sustained virological responders.


METHODS
The study subjects were 1,193 patients with HCV-related chronic liver disease and IFN- or IFN plus ribavirin-induced SVR. The age, male/female ratio, and liver fibrosis stage [(F0-F3)/LC] were 15-83 years, 808/385, and 1106/41, respectively. Patients were followed-up for 8.3 years (range, 0 to 19.0 years) and the incidence of hepatocellular carcinoma was recorded.


RESULTS
Hepatocellular carcinogenesis was detected in 23 patients during the follow-up. The crude rates of hepatocarcinogenesis at 5, 10, and 15 years were 1.5%, 2.4% and 4.1%, respectively. Multivariate analysis identified cirrhosis, male sex and age older than 50 years as determinants of hepatocarcinogenesis with hazard ratios of 12.9 (p<0.001), 6.45 (p=0.012), and 20.2 (p=0.004), respectively.


CONCLUSIONS
Long-term follow-up of patients with chronic HCV infection is necessary even in those who show SVR, especially in male elderly patients with cirrhosis.
Hirakawa
Miharu
M
Department of Hepatology, Toranomon Hospital, Tokyo. ZXC00701@nifty.ne.jp
Ikeda
Kenji
K
Arase
Yasuji
Y
Kawamura
Yusuke
Y
Yatsuji
Hiromi
H
Hosaka
Tetsuya
T
Sezaki
Hitomi
H
Akuta
Norio
N
Kobayashi
Masahiro
M
Saitoh
Satoshi
S
Suzuki
Fumitaka
F
Suzuki
Yoshiyuki
Y
Kumada
Hiromitsu
H
D000293:Adolescent; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000008:administration & dosage / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons