title: Clinical Impact of Viral Load on the Development of Hepatocellular Carcinoma and Liver-Related Mortality in Patients with Hepatitis C Virus Infection.
abstract: Aim. This study aimed to assess clinical impact of hepatitis C viral load on the development of hepatocellular carcinoma (HCC) and liver-related mortality in HCV-infected patients. Methods. A total of 111 subjects with chronic HCV infection who were available for serum quantitation of HCV RNA were recruited in this retrospective cohort. Cox-proportional hazards models were used to calculate hazard ratio (HR) of developing HCC and liver-related mortality according to serum HCV RNA titers. Results. HCC was developed in 14 patients during follow-up period. The cumulative risk of HCC development was higher in subjects with high HCV RNA titer (log HCV RNA IU/mL > 6) than subjects with low titer (log HCV RNA IU/mL ≦ 6) (HR = 4.63, P = 0.032), giving an incidence rate of 474.1 and 111.5 per 10,000 person-years, respectively. Old age (HR = 9.71, P = 0.014), accompanying cirrhosis (HR = 19.34, P = 0.004), and low platelet count (HR = 13.97, P = 0.009) were other independent risk factors for the development of HCC. Liver-related death occurred in 7 patients. Accompanying cirrhosis (HR = 6.13, P = 0.012) and low albumin level (HR = 9.17, P = 0.002), but not HCV RNA titer, were significant risk factors related to liver-related mortality. Conclusion. Serum HCV RNA titer may be considered an independent risk factor for the development of HCC but not liver-related mortality.
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 330-715, Republic of Korea.
authors.forename: Ran
authors.initials: R
authors.lastname: Noh
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 330-715, Republic of Korea.
authors.forename: Doo Hyuck
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 330-715, Republic of Korea.
authors.forename: Byoung Woon
authors.initials: BW
authors.lastname: Kwon
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 330-715, Republic of Korea.
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 330-715, Republic of Korea.
authors.forename: Suk Bae
authors.identifier: 0000-0002-0772-383X
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan 330-715, Republic of Korea.
authors.forename: Il Han
authors.identifier: 0000-0003-3975-6342
authors.initials: IH
authors.lastname: Song