title: Prospective cohort study on the outcomes of hepatitis C virus-related cirrhosis in South Korea.
abstract: OBJECTIVE
  The outcomes of hepatitis C virus (HCV)-related liver cirrhosis was limitedly studied in a hepatitis B virus-endemic area. This multicenter, prospective cohort study was conducted to elucidate the incidence of hepatocellular carcinoma (HCC) and mortality in the Korean patients with HCV-related cirrhosis.
  
  
  METHODS
  From January 2007 through June 2012, 196 patients with HCV-related cirrhosis were prospectively enrolled and regularly followed at six university hospitals to determine HCC occurrence and mortality. A multivariable analysis using Cox proportional hazards regression was performed to clarify the related factors to the outcomes.
  
  
  RESULTS
  During a mean follow-up period of 39.2 months, 31 (15.8%) patients developed HCC, and 33 (16.8%) patients died or underwent liver transplantation. The estimated HCC incidence was 5.8 per 100 person-years, and the independent factors for HCC were absence of anti-HBV surface antibody (HBs hazard ratio [HR], 5.018; 95% confidence interval [CI], 1.710-14.726; P = 0.003) and serum albumin < 3.8 g/dL (HR, 3.051; 95% CI, 1.318-7.067; P = 0.009). The overall mortality rate was 5.1 per 100 person-years, and the related independent factors were the presence of ascites (HR, 2.448; 95% CI, 1.142-5.210; P = 0.022), serum albumin < 3.8 g/dL (HR, 3.067; 95% CI, 1.254-8.139, P = 0.014), and nonachievement of sustained virologic response (SVR) (HR, 0.066; 95% CI, 0.001-0.484, P = 0.002).
  
  
  CONCLUSIONS
  The incidence of HCC in HCV-related cirrhosis seems to be high in Korea, and advanced liver disease and no achievement of SVR were associated with mortality. The absence of anti-HBs in hepatocarcinogenesis related to HCV warrants further study.
authors.affiliation: Department of Internal Medicine, *Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, South Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Sook-Hyang
authors.initials: SH
authors.lastname: Jeong
authors.affiliation: Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Eun Sun
authors.initials: ES
authors.lastname: Jang
authors.affiliation: Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, South Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Youn Jae
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Eun Uk
authors.initials: EU
authors.lastname: Jung
authors.affiliation: Chonbuk National University Hopital, Chonbuk National University College of Medicine, Chonju, South Korea.
authors.forename: In Hee
authors.initials: IH
authors.lastname: Kim
authors.affiliation: The Catholic University of Korea Seoul Saint Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Si Hyun
authors.initials: SH
authors.lastname: Bae
authors.affiliation: Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Han Chu
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Division of AIDS, Korea National Institute of Health, Osong, South Korea.
authors.forename: Mee-Kyung
authors.initials: MK
authors.lastname: Kee
authors.affiliation: Division of AIDS, Korea National Institute of Health, Osong, South Korea.
authors.forename: Chun
authors.initials: C
authors.lastname: Kang
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012709:Serum Albumin; D013997:Time Factors
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D012709:Serum Albumin
keywords: hepatitis B virus; hepatitis C virus; hepatocellular carcinoma; liver cirrhosis; mortality