title: Recognition of infection, status of outpatient treatment, and treatment history before carcinogenesis in patients with viral hepatitis-associated liver cancer.
abstract: We conducted a survey on the recognition of infection, status of outpatient treatment, and treatment history in hepatitis virus-associated hepatocellular carcinoma patients admitted to our department between 2005 and 2014. We compared these parameters in 75 patients with primary hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC) and 307 patients with hepatitis C virus-associated hepatocellular carcinoma (HCV-HCC). Based on the presence or absence of outpatient treatment in medical institutions at the time of HCC diagnosis, the patients were divided into an outpatient treatment-free group or an outpatient treated group. In addition, the latter group was divided into three subgroups depending on the department consulted:the Department of Internal Medicine group, the Department of Gastroenterology group, and a hepatologist-treated group. Patients in the outpatient treatment-free group accounted for 40.0% of patients with HBV-HCC. In the outpatient treated group (60.0%), 21.3% were treated in the Department of Internal Medicine, 22.7% in the Department of Gastroenterology, and 16.0% were treated by a hepatologist. The percentage of HBV-HCC patients in the outpatient treatment-free group was 1.9 times higher than that in the HCV-HCC group and 0.6-fold higher in the hepatologist-treated group. Of the HBV-HCC patients, non-recognizers who were not diagnosed with a viral infection accounted for 21.3%, and non-outpatients who had not consulted a hospital despite the recognition of infection accounted for 33.3%. These percentages were approximately 2 times higher than in HCV-HCC patients. Of the HBV-HCC patients, 66.7% in the hepatologist-treated group had received nucleic acid analogue preparations. On the other hand, one patient in each of the Department of Internal Medicine and Department of Gastroenterology groups (approximately 6.0%) had received a nucleic acid analogue, lamivudine, despite the appearance of a resistant strain. In the HBV-HCC patients, the proportions of "non-recognizers" and "non-outpatients" were higher than in the HCV-HCC patients, suggesting a lack of appropriate treatment.
authors.affiliation: Third Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine.
authors.forename: Michihiko
authors.initials: M
authors.lastname: Shibata
authors.forename: Sota
authors.initials: S
authors.lastname: Minami
authors.forename: Shinji
authors.initials: S
authors.lastname: Oe
authors.forename: Koichiro
authors.initials: K
authors.lastname: Miyagawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Honma
authors.forename: Ryo
authors.initials: R
authors.lastname: Onitsuka
authors.forename: Michio
authors.initials: M
authors.lastname: Senju
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hiura
authors.forename: Riko
authors.initials: R
authors.lastname: Harada
authors.forename: Shintaro
authors.initials: S
authors.lastname: Abe
authors.forename: Akinari
authors.initials: A
authors.lastname: Tabaru
authors.forename: Masaru
authors.initials: M
authors.lastname: Harada
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy / Q000821:virology*; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012307:Risk Factors