title: A cohort study to investigate hepatocellular carcinoma risk in hepatitis C patients.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) frequently occurs with chronic hepatitis C (HCV) infection. This study tried to identify clinical and laboratory factors affecting development of HCC in a longitudinal follow-up of chronic HCV patients.
  
  
  METHODS
  A total of 373 patients with CHC who were HCV RNA-seropositive were recruited during 2000-2003. The remaining 164 patients after application of exclusion criteria (90 males; 74 females; mean age: 58.2 +/- 14y/o) were prospectively recruited and followed-up with periodic liver function tests, alfa-fetoprotein and abdominal ultrasound examinations.
  
  
  RESULTS
  During follow-up between January 2000 and May 2008, HCC was identified in 19 (11.6%) patients. The incidence rate of HCC was 14.5/1,000 person-years. Fifteen patients (9.1%) developed a cirrhotic liver. Male gender (p=0.018), genotype 1b (p=0.034), cirrhosis (p<0.001) and older age (> or = 65y/o) (p=0.02) are significant risk factors for HCC. Overall, there was 2.7-fold increased risk in patients with HCV RNA > or = 1 million copies/mL to develop HCC. The incidence rate of HCC was 8.8% for pegIFNa/RBV-treated patients with sustained viral response and 14.3% for untreated patients (p=0.352).
  
  
  CONCLUSIONS
  This cohort study highlights the roles of male gender, older age and genotype 1b in the progression from chronic HCV to HCC in an area endemic for hepatitis B.
authors.affiliation: Department of Hepato-gastroenterology, Tainan Municipal Hospital, Tainan, Taiwan. chunhsiang@gmail.com
authors.forename: Chun-Hsiang
authors.initials: CH
authors.lastname: Wang
authors.forename: Lein-Ray
authors.initials: LR
authors.lastname: Mo
authors.forename: Kuo-Kwan
authors.initials: KK
authors.lastname: Chang
authors.forename: Ruey-Chang
authors.initials: RC
authors.lastname: Lin
authors.forename: Jen-Juan
authors.initials: JJ
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors
chemical_list: D012367:RNA, Viral