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Risk factors for hepatocellular carcinoma in Japanese patients with autoimmune hepatitis type 1

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Hepatocellular carcinoma (HCC) is occasionally seen even in patients with autoimmune hepatitis (AIH) without prior infection either with hepatitis C virus (HCV) or hepatitis B virus. The aim of this study was to identify the incidence of and risk factors for HCC with AIH in a large-scale population with a long-term follow-up in Japan.

Methods

One hundred and eighty patients diagnosed with AIH were enrolled (F/M = 159/21; mean age, 59.9 years; mean observation period, 80.2 months). Patients with positive HCV antibody/serum HCV RNA and/or positive HBs Ag were excluded. Initial treatment included immunosuppressant therapy (n = 147), other drugs (n = 28), and no drug (n = 5). Patients underwent abdominal ultrasonography at intervals of 3–6 months during observation. Patients’ demographic factors, biochemical data, liver histology, medications, response to treatment, and complications were evaluated in relation to HCC.

Results

During the observation period, six patients (3.3%) developed HCC. Univariate analysis showed that risk factors for HCC were cirrhosis at diagnosis with AIH (p = 0.0002), absence of a treatment response (p = 0.033), abnormal alanine aminotransferase (ALT) at the final observation (p = 0.0002), and diabetes (p = 0.0015). Multivariate analysis showed that risk factors for HCC were cirrhosis at diagnosis of AIH (odds ratio 4.08) and abnormal ALT at final observation (odds ratio 3.66).

Conclusion

This retrospective study showed that cirrhosis at diagnosis of AIH and abnormal ALT at final observation were independently associated with HCC development. It is important to pay attention to the presence of cirrhosis at diagnosis of AIH and to normalize ALT.

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Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Teruko Hino-Arinaga, Tatsuya Ide, Ryoko Kuromatsu, Ichiro Miyajima, Kei Ogata, Reiichiro Kuwahara, Akiko Hisamochi & Michio Sata

  2. Division of Gastroenterology, Department of Medicine, Research Center for Innovative Cancer Therapy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Takuji Torimura

Authors
  1. Teruko Hino-Arinaga
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  2. Tatsuya Ide
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Autoimmune Hepatitis Study Group

Corresponding author

Correspondence to Teruko Hino-Arinaga.

Additional information

The members of the Autoimmune Hepatitis Study Group are listed in the Appendix.

Appendix

Appendix

The members of the Autoimmune Hepatitis Study Group include the following: Drs. Kazunori Noguchi and Hiroto Kumemura, Omuta City Hospital, Omuta, Fukuoka; Drs. Masatoshi Tanaka and Maisa Hori, Kurume University Medical Center, Kurume, Fukuoka; Dr. Kunitaka Fukuizumi, Kyusyu Medical Center, Fukuoka; Dr. Nobuyoshi Tajiri, Social Insurance Tagawa Hospital, Tagawa, Fukuoka; Dr. Kazuhiko Oho, Yanagawa Hospital, Yanagawa, Fukuoka; Dr. Terufumi Sakai, St. Mary’s Hospital, Kurume, Fukuoka; Dr. Ryuichi Nouno, Kumamoto Central Hospital, Kikuchi, Kumamoto; Dr. Hirofumi Fukushima, Saiseikai Futsukaichi Hospital, Futsukaichi, Fukuoka; Dr. Yoichi Yano, Saga Social Insurance Hospital, Saga; Dr. Hiroshi Yoshida, Yame General Hospital, Yame, Fukuoka; Dr. Yasuyo Morita, Nagata Hospital, Yanagawa, Fukuoka; Dr. Kunihide Ishii, Fukuoka Asakura Medical Association Hospital, Asakura, Fukuoka, Dr. Miki Shirachi, Chikugo City Hospital, Chikugo, Fukuoka, Japan.

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Hino-Arinaga, T., Ide, T., Kuromatsu, R. et al. Risk factors for hepatocellular carcinoma in Japanese patients with autoimmune hepatitis type 1. J Gastroenterol 47, 569–576 (2012). https://doi.org/10.1007/s00535-011-0519-2

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  • DOI: https://doi.org/10.1007/s00535-011-0519-2

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