Hepatitis C–associated hepatocellular carcinoma

Abstract

In the United States, a large percentage of patients with hepatocellular carcinoma are serologically negative for hepatitis B. We conducted a retrospective study to determine the prevalence of hepatitis C antibody in the sera of 59 patients with hepatocellular carcinoma who were HBsAg-negative and had no evidence of alcoholic liver disease, primary biliary cirrhosis, autoimmune hepatitis, hemochromatosis or alpha 1-antitrypsin deficiency. Twenty patients (34%) were hepatitis C antibody-positive and hepatitis B core antibody-negative. All twenty patients had underlying cirrhosis, and seven (35%) had histories of transfusions. Eleven (19%) additional patients were also hepatitis C antibody-positive but were hepatitis B core antibody-positive as well. Twenty-one (36%) patients were both hepatitis C antibody- and hepatitis B core antibody-negative and seven (12%) were hepatitis C antibody-negative but hepatitis B core antibody-positive. The prevalence of hepatitis C antibody was also determined among three other population groups serving as controls and found to be 14% in 28 HbsAg-positive patients with hepatocellular carcinoma, 44% in 76 patients with cryptogenic cirrhosis and 0.5% in 200 consecutive volunteer blood donors. We conclude that hepatitis C antibody is prevalent among patients with hepatocellular carcinoma and may therefore be a common causative agent of this disease. A significant number of patients with and without cirrhosis, negative for hepatitis C antibody and hepatitis B core antibody, remain without a discernible cause for this malignancy. Perhaps a second- or third-generation test will detect hepatitis C antibody in some of these patients.

Effect of interferon therapy on hepatocellular carcinogenesis in patients with chronic hepatitis type C: A long-term observation study of 1,643 patients using statistical bias correction with proportional hazard analysis

“…Until recently, hepatitis C virus (HCV) has been reported to be a causative agent of hepatocellular carcinoma (HCC) aside from hepatitis B virus. [1][2][3][4] In two cohort studies from Tokyo 5 and Osaka 6 of Japanese patients with cirrhosis, the cumulative appearance rates of HCC at 3, 5, 10, and 15 years were respectively, 12.5%, 19.4%, 44.3%, and 58.2%. HCC occurred more frequently (75.2% at 15 years) in those patients with only HCV antibodies at enrollment than in those with only hepatitis B surface antigen (27.2%).…”

Colchicine delays the development of hepatocellular carcinoma in patients with hepatitis virus‐related liver cirrhosis

“…1 The reported incidence increased by 48% from 1993 to 2000, from 15,000 to 20,200 cases per year in the U.S. of the tumor or to the presence of liver failure, worsening both long-term prognosis and overall survival (22% at 1 year). 3 The major risk factors for the development of HCC are infection by the hepatitis B virus (HBV), hepatitis C virus (HCV), 4 cirrhosis of any etiology, hemochromatosis, other diseases of hepatic metabolism, and exposure to aflatoxins. 5 The annual risk of developing HCC in patients with cirrhosis is 5%, with a published prevalence at autopsy ranging from 7.4% to 23%.…”

Hepatocytic Proliferation in Chronic Liver Disease: A Study of Liver Biopsies Using Immunohistochemical Localization of Proliferating Cell Nuclear Antigen

“…23 Chronicity of HCV infection leads to CH and LC much more frequently than chronic infection by other hepatitis viruses, 24 and the former infection shows a higher degree of association with hepatocellular carcinoma in several parts of the world. 25 Therefore, we considered it worthwhile to examine for hepatocytic proliferation using PCNA-labeling in our material of chronic liver diseases and to note any differences between hepatitis B-and C-associated diseases.…”