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Progressive fibrosis significantly correlates with hepatocellular carcinoma in patients with a sustained virological response
Author(s) -
Tachi Yoshihiko,
Hirai Takanori,
Miyata Akihiro,
Ohara Kei,
Iida Tadashi,
Ishizu Youji,
Honda Takashi,
Kuzuya Teiji,
Hayashi Kazuhiko,
Ishigami Masatoshi,
Goto Hidemi
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12331
Subject(s) - hepatocellular carcinoma , medicine , gastroenterology , fibrosis , hepatitis c virus , liver biopsy , proportional hazards model , hazard ratio , biopsy , cumulative incidence , carcinoma , hepatitis c , stage (stratigraphy) , hepatitis b virus , oncology , virus , immunology , confidence interval , transplantation , paleontology , biology
Aim Hepatocellular carcinoma develops even in some patients who achieve a sustained virological response following treatment for hepatitis C virus infection. This study investigated the relationship between changes in fibrosis, as assessed by sequential biopsies, and development of hepatocellular carcinoma in patients who achieved a sustained virological response for hepatitis C virus. Methods We enrolled 97 patients with sustained virological response who had undergone initial biopsies before therapy and sequential biopsies at an average of 5.8 ± 1.9 years after the initial biopsy. Factors associated with hepatocellular carcinoma were retrospectively analyzed. Results The liver fibrotic stage regressed in 44 patients (45%), remained stable in 47 patients (48%) and progressed in six patients (6%). The fibrotic stage significantly decreased, from 1.54 ± 0.86 to 1.16 ± 1.07 units. Hepatocellular carcinoma was identified in 12 patients (12.4%). The cumulative incidence of hepatocellular carcinoma in patients with progressive fibrosis was significantly higher than that in patients with regressed or stable fibrosis ( P < 0.001). A C ox proportional hazards regression analysis confirmed that progressive fibrosis in sequential liver biopsies (hazard ratio [ HR ], 8.30; P = 0.001) and low platelet counts before treatment ( HR , 8.69; P = 0.006) were significant independent factors associated with the development of hepatocellular carcinoma in patients with a sustained virological response. Conclusion Progressive fibrosis, assessed by sequential biopsies, was significantly correlated with development of hepatocellular carcinoma in patients who had achieved a sustained virological response for hepatitis C virus.