Digestive Diseases and Sciences

, Volume 56, Issue 6, pp 1853–1861 | Cite as

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

  • José Velosa
  • Fátima Serejo
  • Rui Marinho
  • Joana Nunes
  • Helena Glória
Original Article

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 Cox 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.

Keywords

Hepatitis C virus Cirrhosis Interferon Sustained virological response Hepatocellular carcinoma Mortality 

Abbreviations

HCC

Hepatocellular carcinoma

HBV

Hepatitis B virus

HCV

Hepatitis C virus

IFN

Interferon

RNA

Ribonucleic acid

SVR

Sustained virological response

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • José Velosa
    • 1
  • Fátima Serejo
    • 1
  • Rui Marinho
    • 1
  • Joana Nunes
    • 1
  • Helena Glória
    • 2
  1. 1.Serviço de Gastrenterologia e Hepatologia, Hospital de Santa Maria, Faculdade de MedicinaUniversidade de LisboaLisbonPortugal
  2. 2.Unidade Transplante Hepático, Hospital Curry CabralLisbonPortugal

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