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

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Dig Dis Sci. 2011 Mar 5. [Epub ahead of print]

Eradication of Hepatitis C Virus Reduces the Risk of Hepatocellular Carcinoma in

Patients with Compensated Cirrhosis.

Velosa J, Serejo F, Marinho R, Nunes J, Glória H.

Serviço de Gastrenterologia e Hepatologia, Hospital de Santa , Faculdade de

Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-035, Lisbon,

Portugal, josevelosa@....

Abstract

BACKGROUND: The effect of a sustained virological response (SVR) to interferon

(IFN) on clinical outcomes of hepatitis C virus (HCV)-related cirrhosis is

controversial. Aims: Evaluate the effect of SVR to IFN on the incidence of

hepatocellular carcinoma (HCC) and mortality in patients with compensated

HCV-induced cirrhosis.

METHODS: A cohort of 130 consecutive patients (92 men, mean age 51.7 years) with

histologically proven cirrhosis who received one or more courses of IFN

monotherapy or combination therapy with ribavirin were analyzed. SVR was defined

as undetectable serum HCV RNA by real-time polymerase chain reaction (PCR) 24

weeks after IFN discontinuation. HCC was assessed by alfa-fetoprotein and

ultrasound every 6 months. Predictors of clinical outcomes, defined as HCC,

orthotopic liver transplantation (OLT) and mortality, were assessed by

regression analysis.

RESULTS: The mean follow-up was 6.4 ± 4.0 years (range 1-18). HCC developed in

21 patients: one with SVR versus 20 with non-SVR (P = 0.017). Logistic

regression analysis showed that non-SVR (odds ratio [OR] = 27.0; confidence

interval [CI], 1.6-452.1), male (OR = 11.6; CI, 1.8-75.4), and greater number of

treatments (OR = 4.7; CI, 1.4-16.0) increased the probability of HCC

development. Multivariate analysis found that SVR was associated with lower risk

of HCC (HR 0.09; CI, 0.01-0.77), OLT (HR 0.04; CI, 0.003-0.63) and any event (HR

0.11; CI, 0.02-0.46) as compared to non-SVR.

CONCLUSIONS: In compensated HCV-related cirrhosis, SVR markedly reduces the risk

of HCC and improves survival. Clearance of the virus should be intensively

attempted in these patients.

PMID: 21374066 [PubMed - as supplied by publisher]

[Guest guest]

Dig Dis Sci. 2011 Mar 5. [Epub ahead of print]

Eradication of Hepatitis C Virus Reduces the Risk of Hepatocellular Carcinoma in

Patients with Compensated Cirrhosis.

Velosa J, Serejo F, Marinho R, Nunes J, Glória H.

Serviço de Gastrenterologia e Hepatologia, Hospital de Santa , Faculdade de

Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-035, Lisbon,

Portugal, josevelosa@....

Abstract

BACKGROUND: The effect of a sustained virological response (SVR) to interferon

(IFN) on clinical outcomes of hepatitis C virus (HCV)-related cirrhosis is

controversial. Aims: Evaluate the effect of SVR to IFN on the incidence of

hepatocellular carcinoma (HCC) and mortality in patients with compensated

HCV-induced cirrhosis.

METHODS: A cohort of 130 consecutive patients (92 men, mean age 51.7 years) with

histologically proven cirrhosis who received one or more courses of IFN

monotherapy or combination therapy with ribavirin were analyzed. SVR was defined

as undetectable serum HCV RNA by real-time polymerase chain reaction (PCR) 24

weeks after IFN discontinuation. HCC was assessed by alfa-fetoprotein and

ultrasound every 6 months. Predictors of clinical outcomes, defined as HCC,

orthotopic liver transplantation (OLT) and mortality, were assessed by

regression analysis.

RESULTS: The mean follow-up was 6.4 ± 4.0 years (range 1-18). HCC developed in

21 patients: one with SVR versus 20 with non-SVR (P = 0.017). Logistic

regression analysis showed that non-SVR (odds ratio [OR] = 27.0; confidence

interval [CI], 1.6-452.1), male (OR = 11.6; CI, 1.8-75.4), and greater number of

treatments (OR = 4.7; CI, 1.4-16.0) increased the probability of HCC

development. Multivariate analysis found that SVR was associated with lower risk

of HCC (HR 0.09; CI, 0.01-0.77), OLT (HR 0.04; CI, 0.003-0.63) and any event (HR

0.11; CI, 0.02-0.46) as compared to non-SVR.

CONCLUSIONS: In compensated HCV-related cirrhosis, SVR markedly reduces the risk

of HCC and improves survival. Clearance of the virus should be intensively

attempted in these patients.

PMID: 21374066 [PubMed - as supplied by publisher]