Open AccessImpact of Obesity and Heavy Alcohol Consumption on Hepatocellular Carcinoma Development after HCV Eradication with Antivirals
Author(s) -
Minami Tatsuya,
Tateishi Ryosuke,
Fujiwara Naoto,
Nakagomi Ryo,
Nakatsuka Takuma,
Sato Masaya,
Uchino Koji,
Enooku Kenichiro,
Nakagawa Hayato,
Fujinaga Hidetaka,
Izumiya Masashi,
Hanajiri Kazuyuki,
Asaoka Yoshinari,
Kondo Yuji,
Tanaka Yasuo,
Otsuka Motoyuki,
Ohki Takamasa,
Arai Masahiro,
Tanaka Atsushi,
Yasuda Kiyomi,
Miura Hideaki,
Ogata Itsuro,
Kamoshida Toshiro,
Inoue Kazuaki,
Koike Yukihiro,
Akamatsu Masatoshi,
Mitsui Hiroshi,
Fujie Hajime,
Ogura Keiji,
Yoshida Hideo,
Wada Tomonori,
Kurai Kiyohiko,
Maekawa Hisato,
Obi Shuntaro,
Teratani Takuma,
Masaki Naohiko,
Nagashima Kayo,
Ishikawa Takashi,
Kato Naoya,
Moriya Kyoji,
Yotsuyanagi Hiroshi,
Koike Kazuhiko
Publication year - 2021
Publication title -
liver cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.916
H-Index - 34
eISSN - 1664-5553
pISSN - 2235-1795
DOI - 10.1159/000513705
Subject(s) - original paper
Background and Aims: It remains unclear whether obesity increases the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C who achieved a sustained virological response (SVR) with antiviral therapy. Methods: In this multicenter cohort study, we enrolled patients with chronic hepatitis C who achieved SVR with interferon (IFN)-based therapy (IFN group) or direct-acting antiviral (DAA) therapy (DAA group) between January 1, 1990, and December 31, 2018. The patients underwent regular surveillance for HCC. Cumulative incidence of and the risk factors for HCC development after SVR were assessed using the Kaplan-Meier method and Cox proportional hazard regression analysis, respectively. Results: Among 2,055 patients (840 in the IFN group and 1,215 in the DAA group), 75 developed HCC (41 in the IFN group and 34 in the DAA group) during the mean observation period of 4.1 years. The incidence rates of HCC at 1, 2, and 3 years were 1.2, 1.9, and 3.0%, respectively. Multivariate analysis revealed that in addition to older age, lower albumin level, lower platelet count, higher alpha-fetoprotein level, and absence of dyslipidemia, obesity (body mass index ≥25 kg/m2) and heavy alcohol consumption (≥60 g/day) were independent risk factors for HCC development, with adjusted hazard ratio (HR) of 2.53 (95% confidence interval [CI]: 1.51–4.25) and 2.56 (95% CI: 1.14–5.75), respectively. The adjusted HR was not significant between the 2 groups (DAA vs. IFN; HR 1.19, 95% CI: 0.61–2.33). Conclusions: Obesity and heavy alcohol consumption increased the risk of HCC development after SVR.