title: Hepatic steatosis in chronic hepatitis C is a significant risk factor for developing hepatocellular carcinoma independent of age, sex, obesity, fibrosis stage and response to interferon therapy.
abstract: OBJECTIVE
  Hepatic steatosis is linked to development of hepatocellular carcinoma (HCC) in non-viral liver disease such as non-alcoholic steatohepatitis. The present study aimed to assess whether hepatic steatosis is associated with the development of HCC in chronic hepatitis C.
  
  
  METHODS
  We studied a retrospective cohort of 1279 patients with chronic hepatitis C who received interferon (IFN) therapy between 1994 and 2005 at a single regional hospital in Japan. Of these patients, 393 had a sustained virological response (SVR) and 886 had non-SVR to IFN therapy. After IFN therapy, these patients were screened for development of HCC every 6 months. The average period of observation was 4.5 years.
  
  
  RESULTS
  HCC developed in 68 patients. The annual incidence of HCC was 2.73% for patients with a steatosis grade of 10% or greater and 0.69% for patients with a steatosis grade of 0-9%. On multivariate analysis, higher grade of steatosis was a significant risk factor for HCC independent of older age, male sex, higher body mass index (BMI), advanced fibrosis stage and non-SVR to IFN therapy. The adjusted risk ratio of hepatic steatosis was 3.04 (confidence interval 1.82-5.06, P < 0.0001), which was higher than that of older age (1.09), male sex (2.12), non-SVR to IFN (2.43) and higher BMI (1.69).
  
  
  CONCLUSIONS
  Hepatic steatosis is a significant risk factor for development of HCC in chronic hepatitis C independent of other known risk factors, which suggest the possibility that amelioration of hepatic steatosis may prevent hepatocarcinogenesis.
authors.affiliation: Divisions of Gastroenterology and Hepatologym, Musashino Red Cross Hospital, Tokyo.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kurosaki
authors.forename: Takanori
authors.initials: T
authors.lastname: Hosokawa
authors.forename: Kotaro
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Itsuko
authors.initials: I
authors.lastname: Hirayama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Sato
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Tamaki
authors.forename: Ken
authors.initials: K
authors.lastname: Ueda
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Teiji
authors.initials: T
authors.lastname: Kuzuya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakanishi
authors.forename: June
authors.initials: J
authors.lastname: Itakura
authors.forename: Yuka
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Asahina
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Enomoto
authors.forename: Namiki
authors.initials: N
authors.lastname: Izumi