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Prospective cohort study on the outcomes of hepatitis C virus‐related cirrhosis in S outh K orea
Author(s) -
Lee Sang Soo,
Jeong SookHyang,
Jang Eun Sun,
Kim Young Seok,
Lee Youn Jae,
Jung Eun Uk,
Kim In Hee,
Bae Si Hyun,
Lee Han Chu,
Kee MeeKyung,
Kang Chun
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12950
Subject(s) - medicine , hepatocellular carcinoma , hazard ratio , cirrhosis , gastroenterology , prospective cohort study , ascites , hepatitis c virus , liver transplantation , confidence interval , proportional hazards model , incidence (geometry) , hepatitis c , immunology , transplantation , virus , physics , optics
Background and Aims The outcomes of hepatitis C virus ( HCV )‐related liver cirrhosis was limitedly studied in a hepatitis B virus‐endemic area. This multicenter, prospective cohort study was conducted to elucidate the incidence of hepatocellular carcinoma ( HCC ) and mortality in the K orean patients with HCV ‐related cirrhosis. Methods From J anuary 2007 through J une 2012, 196 patients with HCV ‐related cirrhosis were prospectively enrolled and regularly followed at six university hospitals to determine HCC occurrence and mortality. A multivariable analysis using C ox proportional hazards regression was performed to clarify the related factors to the outcomes. Results During a mean follow‐up period of 39.2 months, 31 (15.8%) patients developed HCC , and 33 (16.8%) patients died or underwent liver transplantation. The estimated HCC incidence was 5.8 per 100 person‐years, and the independent factors for HCC were absence of anti‐HBV surface antibody ( HB s hazard ratio [ HR ], 5.018; 95% confidence interval [ CI ], 1.710–14.726; P = 0.003) and serum albumin < 3.8 g/dL (HR, 3.051; 95% CI , 1.318–7.067; P = 0.009). The overall mortality rate was 5.1 per 100 person‐years, and the related independent factors were the presence of ascites ( HR , 2.448; 95% CI , 1.142–5.210; P = 0.022), serum albumin < 3.8 g/dL ( HR , 3.067; 95% CI , 1.254–8.139, P = 0.014), and nonachievement of sustained virologic response ( SVR ) ( HR , 0.066; 95% CI , 0.001–0.484, P = 0.002). Conclusion The incidence of HCC in HCV ‐related cirrhosis seems to be high in K orea, and advanced liver disease and no achievement of SVR were associated with mortality. The absence of anti‐ HBs in hepatocarcinogenesis related to HCV warrants further study.