Published online Nov 28, 2015. doi: 10.4254/wjh.v7.i27.2757
Peer-review started: June 1, 2015
First decision: July 6, 2015
Revised: August 27, 2015
Accepted: November 13, 2015
Article in press: November 17, 2015
Published online: November 28, 2015
AIM: To investigate risk factors for development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus-related liver cirrhosis (LC-C).
METHODS: To evaluate the relationship between clinical factors including virological response and the development of HCC in patients with LC-C treated with interferon (IFN) and ribavirin, we conducted a multicenter, retrospective study in 14 hospitals in Japan. All patients had compensated LC-C with clinical or histological data available. HCC was diagnosed by the presence of typical hypervascular characteristics on computed tomography and/or magnetic resonance imaging.
RESULTS: HCC was diagnosis in 50 (21.6%) of 231 LC-C patients during a median observation period of 3.8 years after IFN and ribavirin therapy. Patients who developed HCC were older (P = 0.018) and had higher serum levels of pretreatment alpha-fetoprotein (AFP) (P = 0.038). Multivariate analysis revealed the following independent risk factors for HCC development: history of treatment for HCC [P < 0.001, odds ratio (OR) = 15.27, 95%CI: 4.98-59.51], AFP levels of ≥ 10 ng/mL (P = 0.009, OR = 3.89, 95%CI: 1.38-11.94), and des-γ-carboxy prothrombin (DCP) levels of ≥ 40 mAU/mL at 24 wk after the completion of IFN and ribavirin therapy (P < 0.001, OR = 24.43, 95%CI: 4.11-238.67).
CONCLUSION: We suggested that the elevation of AFP and DCP levels at 24 wk after the completion of IFN and ribavirin therapy were strongly associated with the incidence of HCC irrespective of virological response among Japanese LC-C patients.
Core tip: Interferon (IFN)-based therapy reduces the rate of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C virus (HCV) infection. However, HCC development has frequently been reported in HCV-related liver cirrhosis (LC-C) patients who achieved sustained virological response. We conducted a multicenter, retrospective study to evaluate the relationship between clinical factors and HCC development in Japanese LC-C patients treated with IFN and ribavirin therapy. We suggested that the elevation of Alpha-fetoprotein and des-γ-carboxy prothrombin levels at 24 wk after the completion of IFN and ribavirin therapy were strongly associated with the incidence of HCC irrespective of virological response among Japanese LC-C patients.