Hepatocellular carcinoma (HCC) is a frequent cause of mortality in hemophiliacs with chronic viral hepatitis. The early diagnosis of the tumor improves outcome.
In a previous study, annual ultrasound (US) surveillance of hemophiliacs with elevated alanine aminotransferase levels detected multinodular HCC.
In this study, researchers from Italy assessed whether more intense surveillance, using US and alphafetoprotein (AFP) serum levels, in patients with the hepatitis C virus (HCV) would improve identification of single nodule tumors.
The research team divided a multicenter cohort of 559 HCV-infected hemophiliacs into 2 arms. They followed-up 1 of these arms at 6-month intervals, and the other at 12-month intervals.
|Risk of hepatocellular carcinoma increased 12.9-fold with alcohol intake > 80 grams per day.|
During the course of a 6-year surveillance period, HCC was diagnosed in 2% of patients in the 6-month group, and in 1% of patients in the 12-month group.
The researchers found that the overall incidence rate of HCC was 239 per 100 000 per year. The difference in incidence rates between the 2 groups was not significant.
Multivariate analysis showed that the risk of HCC was increased 12.9-fold by an alcohol intake of more than 80 g/d, and 15.2-fold by AFP levels greater than 11 ng/ml.
The team found that liver-related death occurred in 8 cases, including 3 with HCC.
Dr Elena Santagostino's team concluded, "6-month surveillance with US did not increase the chances of detection of single nodule tumors, but it is reasonable to assume that successful treatment of multinodular tumors based upon debulking with chemoembolization and liver transplantation was facilitated by this approach".