Background/aims: Hepatocellular carcinoma (HCC) frequently occurs with chronic hepatitis C (HCV) infection. This study tried to identify clinical and laboratory factors affecting development of HCC in a longitudinal follow-up of chronic HCV patients.
Methodology: A total of 373 patients with CHC who were HCV RNA-seropositive were recruited during 2000-2003. The remaining 164 patients after application of exclusion criteria (90 males; 74 females; mean age: 58.2 +/- 14y/o) were prospectively recruited and followed-up with periodic liver function tests, alfa-fetoprotein and abdominal ultrasound examinations.
Results: During follow-up between January 2000 and May 2008, HCC was identified in 19 (11.6%) patients. The incidence rate of HCC was 14.5/1,000 person-years. Fifteen patients (9.1%) developed a cirrhotic liver. Male gender (p=0.018), genotype 1b (p=0.034), cirrhosis (p<0.001) and older age (> or = 65y/o) (p=0.02) are significant risk factors for HCC. Overall, there was 2.7-fold increased risk in patients with HCV RNA > or = 1 million copies/mL to develop HCC. The incidence rate of HCC was 8.8% for pegIFNa/RBV-treated patients with sustained viral response and 14.3% for untreated patients (p=0.352).
Conclusions: This cohort study highlights the roles of male gender, older age and genotype 1b in the progression from chronic HCV to HCC in an area endemic for hepatitis B.