Hepatitis C virus (HCV) contributes to one third of hepatocellular carcinoma cases worldwide.
Long-term predictors for Hepatitis C virus-related hepatocellular carcinoma are essential for early intervention.
Dr Chien-Jen Chen and colleagues evaluated serum Hepatitis C virus RNA, ALT levels, and Hepatitis C genotype for their predictability of hepatocellular carcinoma risk.
A prospective cohort of 925 participants positive for antibodies against Hepatitis C, and age 30 to 65 years was recruited and followed from 1991 to 2006.
|Hepatocellular carcinoma risk increased to 15% for high HCV RNA levels |
|Journal of Clinical Oncology|
Serum Hepatitis C virus RNA, ALT levels, and Hepatitis C virus genotypes at enrollment and during follow-up were examined.
Newly developed hepatocellular carcinoma was identified by health examination and computerized linkage with national cancer registration and death certification profiles.
The research team found 55 participants with newly developed hepatocellular carcinoma during 8,476 person-years of follow-up, giving an incidence rate of 648.9 per 100,000 person-years.
The cumulative hepatocellular carcinoma risk increased from 1% for Hepatitis C virus RNA seronegative status to 6% for low Hepatitis C virus RNA levels, and to 15% for high Hepatitis C virus RNA levels.
The researchers observed that the cumulative risk also increased with elevated serum ALT levels from about 2% for persistent levels of 15 U/L or less to 4% for ever more than 15 U/L but never more than 45 U/L and to 14% for ALT levels over 45 U/L.
Having Hepatitis C virus genotype 1 was associated with a higher cumulative hepatocellular carcinoma risk than not having Hepatitis C virus genotype 1.
Dr Chen's team concludes, "Elevated serum levels of Hepatitis C virus RNA and ALT and Hepatitis C virus genotype 1 infection are independent risk predictors of hepatocellular carcinoma."
"These findings have strong implications for the management of chronic Hepatitis C virus."