The incidence and risk factors for the development of hepatocellular carcinoma after peginterferon plus ribavirin therapy for chronic hepatitis C

Kazufumi Dohmen, Akira Kawano, Kazuhiro Takahashi, Hirohisa Shigematsu, Hirofumi Tanaka, Masatora Haruno, Kimihoko Yanagita, Yasunori Ichiki, Tetsu Mori, Kazuhiro Hayashida, Shinji Shimoda, Hiromi Ishibashi, Hideyuki Nomura

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Abstract

Background/Aims: Although the incidence of hepatocellular carcinoma (HCC) has been shown to be reduced after pegylated glycol-interferon plus ribavirin (Peg-IFN/RBV) therapy in patients with chronic hepatitis C, the risk factors for the development of HCC are not fully understood. The aim of this study was to clarify the incidence and the risk factors for the development of HCC after Peg-IFN/RBV therapy in patients with chronic hepatitis C. Methodology: A total of 474 patients with chronic hepatitis C who received Peg-IFN/RBV therapy between December 2004 and August 2010 were enrolled and followed in a multicenter trial. The patients were assessed for HCC by either ultrasound or computed tomography every 6 months. The incidence and risk factors for the development of HCC were identified. Results: Of the 474 patients, 23 developed HCC during a median follow-up of 4 years and 8 months (range 1-6 years and 3 months) after completion of Peg-IFN/RBV therapy. According to a univariate analysis, higher age, low platelet counts, a low level of serum albumin, a high level of alpha-fetoprotein (AFP) and a sustained viral response (SVR) to Peg-IFN/RBV therapy were independent factors associated with the occurrence of HCC. The multivariate analysis using the Cox proportional hazard model revealed the risk factors for HCC were the platelet count, AFP level and the outcome of Peg-IFN/RBV therapy. Conclusions: To reduce the incidence of HCC in chronic hepatitis C, attainment of a sustained response rate is an essential issue. For patients with low platelet counts and/or a high AFP level, strict surveillance should be continued even after eradication of HCV because the risk of HCC was found to be higher for these patients.

Original languageEnglish
Pages (from-to)2034-2038
Number of pages5
JournalHepato-gastroenterology
Volume60
Issue number128
DOIs
Publication statusPublished - Nov 1 2013

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Ribavirin
Chronic Hepatitis C
Hepatocellular Carcinoma
Glycols
Incidence
Interferons
alpha-Fetoproteins
Platelet Count
Therapeutics
Proportional Hazards Models
Serum Albumin
Multicenter Studies
Multivariate Analysis
Tomography

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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The incidence and risk factors for the development of hepatocellular carcinoma after peginterferon plus ribavirin therapy for chronic hepatitis C. / Dohmen, Kazufumi; Kawano, Akira; Takahashi, Kazuhiro; Shigematsu, Hirohisa; Tanaka, Hirofumi; Haruno, Masatora; Yanagita, Kimihoko; Ichiki, Yasunori; Mori, Tetsu; Hayashida, Kazuhiro; Shimoda, Shinji; Ishibashi, Hiromi; Nomura, Hideyuki.

In: Hepato-gastroenterology, Vol. 60, No. 128, 01.11.2013, p. 2034-2038.

Research output: Contribution to journalArticle

Dohmen, K, Kawano, A, Takahashi, K, Shigematsu, H, Tanaka, H, Haruno, M, Yanagita, K, Ichiki, Y, Mori, T, Hayashida, K, Shimoda, S, Ishibashi, H & Nomura, H 2013, 'The incidence and risk factors for the development of hepatocellular carcinoma after peginterferon plus ribavirin therapy for chronic hepatitis C', Hepato-gastroenterology, vol. 60, no. 128, pp. 2034-2038. https://doi.org/10.5754/hge11716
Dohmen, Kazufumi ; Kawano, Akira ; Takahashi, Kazuhiro ; Shigematsu, Hirohisa ; Tanaka, Hirofumi ; Haruno, Masatora ; Yanagita, Kimihoko ; Ichiki, Yasunori ; Mori, Tetsu ; Hayashida, Kazuhiro ; Shimoda, Shinji ; Ishibashi, Hiromi ; Nomura, Hideyuki. / The incidence and risk factors for the development of hepatocellular carcinoma after peginterferon plus ribavirin therapy for chronic hepatitis C. In: Hepato-gastroenterology. 2013 ; Vol. 60, No. 128. pp. 2034-2038.
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T1 - The incidence and risk factors for the development of hepatocellular carcinoma after peginterferon plus ribavirin therapy for chronic hepatitis C

AU - Dohmen, Kazufumi

AU - Kawano, Akira

AU - Takahashi, Kazuhiro

AU - Shigematsu, Hirohisa

AU - Tanaka, Hirofumi

AU - Haruno, Masatora

AU - Yanagita, Kimihoko

AU - Ichiki, Yasunori

AU - Mori, Tetsu

AU - Hayashida, Kazuhiro

AU - Shimoda, Shinji

AU - Ishibashi, Hiromi

AU - Nomura, Hideyuki

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Background/Aims: Although the incidence of hepatocellular carcinoma (HCC) has been shown to be reduced after pegylated glycol-interferon plus ribavirin (Peg-IFN/RBV) therapy in patients with chronic hepatitis C, the risk factors for the development of HCC are not fully understood. The aim of this study was to clarify the incidence and the risk factors for the development of HCC after Peg-IFN/RBV therapy in patients with chronic hepatitis C. Methodology: A total of 474 patients with chronic hepatitis C who received Peg-IFN/RBV therapy between December 2004 and August 2010 were enrolled and followed in a multicenter trial. The patients were assessed for HCC by either ultrasound or computed tomography every 6 months. The incidence and risk factors for the development of HCC were identified. Results: Of the 474 patients, 23 developed HCC during a median follow-up of 4 years and 8 months (range 1-6 years and 3 months) after completion of Peg-IFN/RBV therapy. According to a univariate analysis, higher age, low platelet counts, a low level of serum albumin, a high level of alpha-fetoprotein (AFP) and a sustained viral response (SVR) to Peg-IFN/RBV therapy were independent factors associated with the occurrence of HCC. The multivariate analysis using the Cox proportional hazard model revealed the risk factors for HCC were the platelet count, AFP level and the outcome of Peg-IFN/RBV therapy. Conclusions: To reduce the incidence of HCC in chronic hepatitis C, attainment of a sustained response rate is an essential issue. For patients with low platelet counts and/or a high AFP level, strict surveillance should be continued even after eradication of HCV because the risk of HCC was found to be higher for these patients.

AB - Background/Aims: Although the incidence of hepatocellular carcinoma (HCC) has been shown to be reduced after pegylated glycol-interferon plus ribavirin (Peg-IFN/RBV) therapy in patients with chronic hepatitis C, the risk factors for the development of HCC are not fully understood. The aim of this study was to clarify the incidence and the risk factors for the development of HCC after Peg-IFN/RBV therapy in patients with chronic hepatitis C. Methodology: A total of 474 patients with chronic hepatitis C who received Peg-IFN/RBV therapy between December 2004 and August 2010 were enrolled and followed in a multicenter trial. The patients were assessed for HCC by either ultrasound or computed tomography every 6 months. The incidence and risk factors for the development of HCC were identified. Results: Of the 474 patients, 23 developed HCC during a median follow-up of 4 years and 8 months (range 1-6 years and 3 months) after completion of Peg-IFN/RBV therapy. According to a univariate analysis, higher age, low platelet counts, a low level of serum albumin, a high level of alpha-fetoprotein (AFP) and a sustained viral response (SVR) to Peg-IFN/RBV therapy were independent factors associated with the occurrence of HCC. The multivariate analysis using the Cox proportional hazard model revealed the risk factors for HCC were the platelet count, AFP level and the outcome of Peg-IFN/RBV therapy. Conclusions: To reduce the incidence of HCC in chronic hepatitis C, attainment of a sustained response rate is an essential issue. For patients with low platelet counts and/or a high AFP level, strict surveillance should be continued even after eradication of HCV because the risk of HCC was found to be higher for these patients.

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