title: Patients with chronic hepatitis C without advanced fibrosis and hepatocellular carcinoma: a retrospective clinical-pathological study.
abstract: BACKGROUND
  There are very few studies on the incidence and risk factors of hepatitis C virus (HCV)-induced hepatocellular carcinoma (HCC) in the absence of advanced fibrosis. Our objective was to identify the clinical-pathological features of these patients.
  
  
  METHODS
  We retrospectively reviewed 162 patients admitted to our hospital for HCV-related HCC between 2000 and 2010. Patients with hepatitis of other aetiologies, human immunodeficiency virus co-infection, or treated with interferon were excluded. We compared demographic, laboratory, clinical and outcome parameters of patients with and without advanced fibrosis.
  
  
  RESULTS
  137 patients had advanced fibrosis (85%). Median age was higher in the advanced fibrosis vs. the non-advanced fibrosis group (62 vs. 65 years, respectively; p = 0.025). Steatosis was significantly more frequent in patients with advanced fibrosis compared to those without advanced fibrosis (43% vs. 20%, respectively; p = 0.032). Independent predictors associated to the occurrence of HCC in patients without advanced fibrosis were hepatitis B core antigen (odds ratio: 3.86; p = 0.044) and duration of hepatitis C infection (odds ratio: 1.21; p = 0.003).
  
  
  CONCLUSIONS
  Risk factors such as steatosis or diabetes were not frequent in patients without advanced fibrosis. Further studies are needed to evaluate the role of occult hepatitis B and the duration of hepatitis infection in patients with HCC and chronic hepatitis C without advanced fibrosis.
authors.affiliation: Department of Hepatology, Beaujon Hospital, AP-HP, Clichy, France; INSERM U1137, University Paris 7, UFR of Medicine, France; INSERM U1149/CRI, Beaujon Hospital, AP-HP, Clichy, France. Electronic address: blaise.kutala@bjn.aphp.fr.
authors.forename: Blaise
authors.initials: B
authors.lastname: K-Kutala
authors.affiliation: Department of Pathology, Beaujon Hospital, AP-HP, Clichy, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.affiliation: INSERM U1137, University Paris 7, UFR of Medicine, France.
authors.forename: Jeremie
authors.initials: J
authors.lastname: Guedj
authors.affiliation: Department of Hepatology, Beaujon Hospital, AP-HP, Clichy, France; INSERM U1149/CRI, Beaujon Hospital, AP-HP, Clichy, France.
authors.forename: Tarik
authors.initials: T
authors.lastname: Asselah
authors.affiliation: INSERM U1149/CRI, Beaujon Hospital, AP-HP, Clichy, France.
authors.forename: Michelle
authors.initials: M
authors.lastname: Martinot-Peignoux
authors.affiliation: INSERM U1137, University Paris 7, UFR of Medicine, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Duval
authors.affiliation: Department of Hepatology, Beaujon Hospital, AP-HP, Clichy, France; INSERM U1149/CRI, Beaujon Hospital, AP-HP, Clichy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Marcellin
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005602:France / Q000453:epidemiology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Cirrhosis; Hepatitis C; Hepatocellular carcinoma; Nonalcoholic steatohepatitis; Screening