Brief Article
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World J Gastroenterol. Mar 28, 2012; 18(12): 1385-1390
Published online Mar 28, 2012. doi: 10.3748/wjg.v18.i12.1385
Assessment of disease progression in patients with transfusion-associated chronic hepatitis C using transient elastography
Ryota Masuzaki, Ryosuke Tateishi, Haruhiko Yoshida, Toru Arano, Koji Uchino, Kenichiro Enooku, Eriko Goto, Hayato Nakagawa, Yoshinari Asaoka, Yuji Kondo, Tadashi Goto, Hitoshi Ikeda, Shuichiro Shiina, Masao Omata, Kazuhiko Koike
Ryota Masuzaki, Ryosuke Tateishi, Haruhiko Yoshida, Toru Arano, Koji Uchino, Kenichiro Enooku, Eriko Goto, Hayato Nakagawa, Yoshinari Asaoka, Yuji Kondo, Tadashi Goto, Shuichiro Shiina, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 1138655 Tokyo, Japan
Hitoshi Ikeda, Department of Clinical Laboratory, The University of Tokyo Hospital, 1138655 Tokyo, Japan
Masao Omata, Yamanashi Prefectural Hospital Organization, 4008506 Yamanashi, Japan
Author contributions: Masuzaki R, Tateishi R and Yoshida H designed research; Masuzaki R, Arano T, Uchino K, Enooku K, Goto E, Nakagawa H, Asaoka Y, Kondo Y and Goto T collected data; Tateishi R and Yoshida H analyzed data; Masuzaki R and Yoshida H wrote the paper; Tateishi R, Ikeda H and Shiina S reviewed the paper; Omata M and Koike K supervised the entire project.
Correspondence to: Dr. Ryota Masuzaki, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655 Tokyo, Japan. ryota-m@umin.net
Telephone: +81-3-38155411 Fax: +81-3-38140021
Received: May 12, 2011
Revised: August 1, 2011
Accepted: January 22, 2012
Published online: March 28, 2012
Abstract

AIM: To evaluate the relationship between liver stiffness and duration of infection in blood transfusion-associated hepatitis C virus (HCV) patients with or without hepatocellular carcinoma (HCC).

METHODS: Between December 2006 and June 2008, a total of 524 transfusion-associated HCV-RNA positive patients with or without HCC were enrolled. Liver stiffness was obtained noninvasively by using Fibroscan (Echosens, Paris, France). The date of blood transfusion was obtained by interview. Duration of infection was derived from the interval between the date of blood transfusion and the date of liver stiffness measurement (LSM). Patients were stratified into four groups based on the duration of infection (17-29 years; 30-39 years; 40-49 years; and 50-70 years). The difference in liver stiffness between patients with and without HCC was assessed in each group. Multiple linear regression analysis was used to determine the factors associated with liver stiffness.

RESULTS: A total of 524 patients underwent LSM. Eight patients were excluded because of unsuccessful measurements. Thus 516 patients were included in the current analysis (225 with HCC and 291 without). The patients were 244 men and 272 women, with a mean age of 67.8 ± 9.5 years. The median liver stiffness was 14.3 kPa (25.8 in HCC group and 7.6 in non-HCC group). The patients who developed HCC in short duration of infection were male dominant, having lower platelet count, with a history of heavier alcohol consumption, showing higher liver stiffness, and receiving blood transfusion at an old age. Liver stiffness was positively correlated with duration of infection in patients without HCC (r = 0.132, P = 0.024) but not in patients with HCC (r = -0.103, P = 0.123). Liver stiffness was significantly higher in patients with HCC than in those without in each duration group (P < 0.0001). The factors significantly associated with high liver stiffness in multiple regression were age at blood transfusion (P < 0.0001), duration of infection (P = 0.0015), and heavy alcohol consumption (P = 0.043)

CONCLUSION: Although liver stiffness gradually increases over time, HCC develops in patients with high stiffness value regardless of the duration of infection.

Keywords: Transfusion-associated hepatitis C; Transient elastography; Hepatocellular carcinoma; Liver stiffness; Ultrasonography; Liver fibrosis