Virological and biochemical features in elderly HCV patients with hepatocellular carcinoma: amino acid substitutions in HCV core region as predictor of mortality after first treatment.
OBJECTIVE
We showed previously that amino acid (aa) substitutions in HCV genotype 1b (HCV-1b) core region are negative predictors of virological response to peginterferon + ribavirin therapy, and also risk factors of hepatocarcinogenesis. The aim of this study was to evaluate the impact of core aa substitutions on mortality in elderly patients.


METHODS
We compared the characteristics and survival of 92 elderly (> or =75 years) patients with HCV-related hepatocellular carcinoma (HCC) (including 62 patients with HCV-1b) with those of 44 younger patients (<50 years, 34 patients with HCV-1b).


RESULTS
For all patients, univariate analysis identified female sex, history of blood transfusion, preserved liver function and glucose metabolism as significant variables in the elderly patients. In patients with HCV-1b-related HCC, univariate analysis identified preserved lipid metabolism as significant variable in addition to significant variables in overall patients. In elderly patients with HCV-1b-related HCC, multivariate analysis identified male sex, methionine of core aa91, and non-radical therapy as factors that influenced mortality after first treatment for HCC.


CONCLUSIONS
Our results characterized elderly patients who develop HCC after HCV-1b infection, and suggested that aa substitutions of HCV-1b core region correlate with mortality of patients after first treatment for HCC.
Ogura
Suguru
S
Department of Hepatology, Toranomon Hospital, Tokyo, Japan. suguru-o@toranomon.gr.jp
Akuta
Norio
N
Hirakawa
Miharu
M
Kawamura
Yusuke
Y
Yatsuji
Hiromi
H
Sezaki
Hitomi
H
Hosaka
Tetsuya
T
Kobayashi
Masahiro
M
Suzuki
Fumitaka
F
Suzuki
Yoshiyuki
Y
Kobayashi
Mariko
M
Saitoh
Satoshi
S
Arase
Yasuji
Y
Ikeda
Kenji
K
Kumada
Hiromitsu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019943:Amino Acid Substitution / Q000235:genetics*; D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000821:virology*; D005260:Female; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D016019:Survival Analysis; D014758:Viral Core Proteins / Q000235:genetics*
D000998:Antiviral Agents; D014758:Viral Core Proteins; C069130:nucleocapsid protein, Hepatitis C virus