title: Hepatocellular carcinoma in patients with autoimmune hepatitis.
abstract: OBJECTIVE
  To evaluate and confirm the low incidence of hepatocellular carcinoma (HCC) in patients with autoimmune hepatitis (AIH). At present only very few cases of HCC in patients with AIH and definite exclusion of chronic viral hepatitis have been published, suggesting that HCC due to AIH is rare.
  
  
  METHODS
  In order to further investigate the incidence of HCC in patients with AIH, we reviewed our large cohort of 278 patients with AIH.
  
  
  RESULTS
  Eighty-nine patients (32%) were diagnosed with liver cirrhosis, a preneoplastic condition for HCC. We studied a total of 431 patient years of cirrhosis in these patients, an average 4.8 years per patient. During this period none of the patients of our own study cohort developed HCC. However, three patients with HCC due to AIH associated liver cirrhosis were referred to our department for further treatment of HCC. In all three patients chronic viral hepatitis was excluded.
  
  
  CONCLUSIONS
  We conclude that HCC may under rare circumstances develop due to chronic AIH dependent liver cirrhosis. Compared to other causes of liver cirrhosis such as chronic viral hepatitis, alcohol, or hemochromatosis, the incidence of HCC is significantly lower. Pathophysiological differences between AIH and chronic viral hepatitis responsible for differences in the incidence of HCC are yet to be further characterized and may lead to new therapeutic concepts in prevention and treatment of liver cancer.
authors.affiliation: Department of Medicine I, Johannes Gutenberg University, Mainz 55101, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Teufel
authors.forename: Arndt
authors.initials: A
authors.lastname: Weinmann
authors.forename: Catherine
authors.initials: C
authors.lastname: Centner
authors.forename: Anja
authors.initials: A
authors.lastname: Piendl
authors.forename: Ansgar W
authors.initials: AW
authors.lastname: Lohse
authors.forename: Peter R
authors.initials: PR
authors.lastname: Galle
authors.forename: Stephan
authors.initials: S
authors.lastname: Kanzler
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D001208:Asia / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D015331:Cohort Studies; D019049:Developed Countries / Q000706:statistics & numerical data; D005260:Female; D006432:Hemochromatosis / Q000150:complications; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D019693:Hepatitis, Autoimmune / Q000150:complications*; D006801:Humans; D015994:Incidence; D008105:Liver Cirrhosis, Biliary / Q000150:complications; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged