Hepatic steatosis as a possible risk factor for the development of hepatocellular carcinoma after eradication of hepatitis C virus with antiviral therapy in patients with chronic hepatitis C

Abstract

AIM:To elucidate risk factors contributing to the development of hepatocellular carcinoma (HCC) among patients with sustained viral response (SVR) after interferon (IFN) treatment and to examine whether HCV-RNA still remained in the liver of SVR patients who developed HCC. METHODS:Two-hundred and sixty-six patients, who achieved SVR, were enrolled in this study. We retrospectively reviewed clinical, viral and histological features of the patients, and examined whether the development of HCC depends on several clinical variables using Kaplan-Meier Method. RT-PCR was used to seek HCV-RNA in 3 out of 7 patients in whom liver tissue was available for molecular analysis. RESULTS:Among the enrolled 266 patients with SVR, HCC developed in 7 patients (7/266; 2.6%). We failed to detect HCV-RNA both in cancer and non-cancerous liver tissue in all three patients. The cumulative incidence for HCC was significantly different depending on hepatic fibrosis (F3-4) (P = 0.0028), hepatic steatosis (Grade 2-3) (P = 0.0002) and age (≥ 55) (P = 0.021) at the pre-interferon treatment. CONCLUSION:The current study demonstrated that age, hepatic fibrosis, and hepatic steatosis at preinterferon treatment might be risk factors for developing HCC after SVR.

Long-Term Outcomes of Hepatitis-C-Infected Patients Achieving a Sustained Virological Response and Undergoing Radical Treatment for Hepatocellular Carcinoma

“…There have also been many studies on the risk factors for the development of HCC after SVR has been achieved [16,17,18,19]. Some studies found that elevated AFP level at baseline, older age, male gender, and advanced stage of liver fibrosis were independent risk factors for HCC in patients with HCV infections [20,21].…”

Eradication of Hepatitis C Virus Reduces the Risk of Hepatocellular Carcinoma in Patients with Compensated Cirrhosis

“…However, it is not clear whether the same factors are also responsible at cirrhotic staging [30,31]. It was reported that alcohol [32], occult infection with hepatitis B virus (HBV) [33], and hepatic steatosis [34] could maintain hepatocyte turnover after the eradication of HCV and increase the risk for HCC.…”

Predictive Value of the Fibrosis Scores in Patients with Chronic Hepatitis C Associated with Liver Fibrosis and Metabolic Syndrome

“…Previous studies have demonstrated the association between metabolic syndrome and hepatic fibrosis in patients with hepatitis C (6)(7)(8)(9)(10)(11). Steatosis is a frequent histological finding in chronic hepatitis C virus infection, one that affects disease progression and occurrence of hepatocellular carcinoma (7,(12)(13)(14)(15). Hepatic steatosis is associated with metabolic syndrome and non-alcoholic steatohepatitis (NASH).…”