Hepatocellular carcinoma in patients with chronic hepatitis C virus infection without cirrhosis.
OBJECTIVE
To investigate and characterise patients with chronic hepatitis C virus (HCV) infection presenting with hepatocellular carcinoma (HCC) in the absence of cirrhosis.


METHODS
Patients with chronic hepatitis C infection without cirrhosis presenting with HCC over a 2-year period were identified. The clinical case notes, blood test results and histological specimens were reviewed to identify whether additional risk factors for the development of HCC were present.


RESULTS
Six patients (five male, one female) with chronic hepatitis C infection without cirrhosis presented to a single centre with HCC over a 2-year period. Five patients were treated by surgical resection and one patient underwent liver transplantation. Evaluation of generous histological specimens confirmed the presence of HCC and the absence of cirrhosis in all cases. The degree of fibrosis of the background liver was staged as mild (n = 1), moderate (n = 4) or bridging fibrosis (n = 1). Review of the clinical case notes revealed that all cases had an additional risk factor for the development of HCC (four had evidence of past hepatitis B virus infection; two had a history of excessive alcohol consumption; a further patient had prolonged exposure to immune suppression).


CONCLUSIONS
HCC does occur in patients with non-cirrhotic HCV infection who have other risk factors for hepatocarcinogenesis.
Nash
Kathryn L
KL
Department of Hepatology, Southampton General Hospital, Tremona Road, Southampton, Hampshire, United Kingdom. klnash11@yahoo.co.uk
Woodall
Tracy
T
Brown
Ashley S M
AS
Davies
Susan E
SE
Alexander
Graeme J M
GJ
D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006515:Hepatitis B virus / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008113:Liver Neoplasms / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D000914:Antibodies, Viral