Characteristics of Anti-HCV Antibody-Positive Patients with Hepatocellular Carcinoma on Chronic Hemodialysis: Recommendation of Periodic Ultrasonography for Early Detection

Sakai, Yoshinori; Izumi, Namiki; Tazawa, Junichi; Uchihara, Masakatsu; Akiba, Takashi; Marumo, Fumiaki; Sato, Chifumi

doi:10.1159/000189340

Cited by 6 publications

(3 citation statements)

References 10 publications

(13 reference statements)

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“…In the present study, the elevation of serum ALT above twice the normal range was observed in only 1 of 9 patients with chronic hepatitis C, and in some patients, serum aminotransferase levels were kept within the normal range despite histological findings of chronic active hepatitis. Recently, Sakai et al [23]reported that liver function tests were within the normal range in most patients with hepatocellular carcinoma associated with HCV infection in hemodialysis patients. Therefore, physicians should be careful not to miss liver cirrhosis or hepatocellular carcinoma in HCV carriers undergoing hemodialysis even if their serum aminotransferase levels are within the normal range.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, histopathological examination is necessary in hemodialysis patients with chronic HCV infection even if their serum aminotransferase levels are kept within the normal range. Similarly, ultrasonography and/or computed tomography should be performed in these patients in order to detect small hepatocellular carcinoma [23]. From these results, IFN therapy should be indicated in hemodialysis patients before developing hepatocellular carcinoma [24].…”

Section: Discussionmentioning

confidence: 99%

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Interferon Therapy for Chronic Hepatitis C in Hemodialysis Patients: Increased Serum Levels of Interferon

Uchihara

Izumi

Sakai

et al. 1998

Nephron

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Background/Aims: The efficacy and side effects of interferon (IFN) therapy have not been well clarified in hemodialysis patients with chronic hepatitis C. Methods: In 6 of 9 hemodialysis patients with chronic hepatitis C, 3 million units (MU) or 6 MU of recombinant IFN-α2b or natural IFN-α were administered intramuscularly daily for the first 2 weeks, followed by three times a week for 22 weeks. In the remaining 3 patients, 3 MU of IFN-α2b were given three times a week for 24 weeks. Serum concentrations of IFN-α2b were measured sequentially after the injection of interferon. Responders were defined as the patients with normal serum aminotransferase and negative serum HCV RNA 6 months after the cessation of IFN therapy. Results: Three of the 6 patients who were administered IFN daily in the first 2 weeks were responders, while the other 3 withdrew from the therapy due to serious adverse events such as depression, loss of consciousness and persistence of high-grade fever. Serious adverse events were not observed in the 3 patients without daily administration. Half-lives of IFN-α2b in hemodialysis patients were significantly longer than those in nonuremic patients (10.0 vs. 6.0 h, p < 0.05). Moreover, the areas under the serum concentration curve of the hemodialysis patients were significantly larger than those of nonuremic patients (756 ± 223 vs. 324 ± 223 IU·h/ml, p < 0.05), despite the fact that the dose of IFN-α administered to hemodialysis patients was half that administered to nonuremic patients. Conclusions: In hemodialysis patients with chronic hepatitis C, pharmacokinetic parameters of IFN may be different from those in nonuremic patients, and daily or high-dose administration of IFN may lead to serious adverse events in those patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interferon Therapy for Chronic Hepatitis C in Hemodialysis Patients: Increased Serum Levels of Interferon

Uchihara

Izumi

Sakai

et al. 1998

Nephron

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“…A previous study published in 1996 found that the frequency of HCV-positive HD patients was as high as 18.9% (409/2,164), while HCC was observed in only 2.4% (10/409) of HD patients with HCV infection (19). Factors associated with HCC in HCV-positive HD patients have remained elusive.…”

Section: Discussionmentioning

confidence: 96%

Clinical features of hemodialysis patients treated for hepatocellular carcinoma: Comparison between resection and radiofrequency ablation

Hiraoka

Kumada

Michitaka

et al. 2017

Molecular and Clinical Oncology

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There is no consensus regarding which therapeutic option is better and/or safer for treating hemodialysis (HD) patients with hepatocellular carcinoma (HCC). The present study compared surgical resection (Hx) and radiofrequency ablation (RFA) with regard to therapeutic efficacy in HD patients with HCC. Of 108 HD patients with naïve HCC treated at 15 institutions between 1988 and 2014 enrolled in the present study, 58 fulfilled the up-to-7 criteria [7 as the sum of the size of the largest tumor (cm) and the number of tumors] and were treated with Hx (n=23) or RFA (n=35); their clinical features, complications and prognosis were assessed. The frequency of hepatitis C virus was higher in the RFA group compared with that in the Hx group (P=0.002), whereas there were no differences between the groups with regard to the average time from the first HD (P=0.953), tumor-nodes-metastasis (TNM) stage (Union for International Cancer Control 7th edition) (P=0.588), TNM stage (Liver Cancer Study Group of Japan 5th edition) (P=0.095), Child-Pugh classification (P=0.094), and Japan Integrated Scoring system (P=0.489). There were no significant differences in overall survival (OS) and disease-free survival (DFS) rates between the Hx and RFA groups [1-, 3- and 5-year OS rates: 81.7, 55.6 and 43.3% vs. 89.9, 67.1 and 56.3%, respectively (P=0.454); 1-, 3- and 5-year DFS rates: 71.1, 30.5 and 18.3% vs. 63.8, 31.6 and 21.1%, respectively (P=0.911)] Complications were observed in 4 patients (11.4%) in the RFA group (2 with subcapsular hemorrhage, 1 with intraperitoneal bleeding and 1 with tardive intrahepatic hematoma) and in 4 patients (17.4%) in the Hx group (2 with postoperative infection, 1 with liver failure and 1 with pleural effusion) (P=0.700). In conclusion, Hx and RFA have a similar therapeutic efficacy in HD patients with naïve HCC who fulfilled the up-to-7 criteria.

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Liver resection for hepatocellular carcinoma in patients with end‐stage renal failure

Cheng

Shu

et al. 2001

Journal of Surgical Oncology

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Characteristics of Anti-HCV Antibody-Positive Patients with Hepatocellular Carcinoma on Chronic Hemodialysis: Recommendation of Periodic Ultrasonography for Early Detection

Cited by 6 publications

References 10 publications

Interferon Therapy for Chronic Hepatitis C in Hemodialysis Patients: Increased Serum Levels of Interferon

Interferon Therapy for Chronic Hepatitis C in Hemodialysis Patients: Increased Serum Levels of Interferon

Clinical features of hemodialysis patients treated for hepatocellular carcinoma: Comparison between resection and radiofrequency ablation

Liver resection for hepatocellular carcinoma in patients with end‐stage renal failure

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