RISK FACTORS FOR DEVELOPMENT OF HEPATOCELLULAR CARCINOMA IN CHRONIC HEPATITIS C AFTER SVR TO PEG/RBV THERAPY

EASL;Session Title: Category 08c: Viral Hepatitis C: Clinical (therapy)


Presentation Date: 31 MAR, 2011

RISK FACTORS FOR DEVELOPMENT OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH CHRONIC HEPATITIS C AFTER SUSTAINED RESPONSE TO PEGINTERFERON AND RIBAVIRIN COMBINATION THERAPY

K.-C. Chang1*, T.-H. Hu2

1Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, 2Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan R.O.C.. *ux2551207@yahoo.com.tw

Background/aims: Antiviral therapy could prevent the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV). However, HCC still develop in a portion HCV patients after sustained virologic response (SVR). The aim of present study is to evaluate the risk factors of HCC development in HCV patients after SVR to peg-IFN combination therapy.

Methods: Seven hundred and six CHC patients receiving peg-IFN and oral ribavirin for 24 or 48 weeks who achieving SVR were analyzed from March 2002 to October 2009. Cumulative incidence of HCC was estimated by the Kaplan-Meier method. The prognostic relevance of clinical variables and HCC occurrence was evaluated by univariate analysis with the log-rank test and by multivariate Cox's regression analysis.

Results: During a median follow-up period of 32.9 months , HCC developed in 13 patients with SVR. Cumulative incidence of HCC was 0.8 % in 1-yr, 1.2 % in 3-yr, and 3.0 % in 5-yr. Kaplan-Meier analysis revealed that old age (≥60 years) (P < 0.001), male gender (P=0.013), advanced fibrosis (3-4) (P< 0.001), low platelet count (< 100x109/L) (P < 0.001) and AFP levels (≥ 20ng/ml) (P< 0.001) were associated with HCC occurrence. Multivariate analysis revealed old age (hazard ratio (HR):12.47, 95% confidence interval (CI): 1.60-96.67), male gender (HR: 5.71, 95% CI: 1.27-25.91), low platelet count (HR: 3.47, 95% CI: 1.13-10.62) and advanced fibrosis (HR: 8.91, 95% CI: 1.11-71.42) were independent risk factors.

Conclusions: The current study demonstrated that HCV patients with old age, male gender, advanced hepatic fibrosis, and low platelet count at baseline of HCV therapy need more close follow-up even after SVR to peg-IFN combination therapy.

http://www1.easl.eu/easl2011/program/Posters/Abstract215.htm