Risk factors for hepatocellular carcinoma after sustained virologic response in patients with chronic hepatitis C virus infection / 中华传染病杂志

ABSTRACT

Objective:To investigate the risk factors for hepatocellular carcinoma (HCC) after sustained virologic response (SVR) in patients with chronic hepatitis C virus (HCV) infection.Methods:Patients with chronic HCV infection who were treated in Tianjin Second People′s Hospital from January 2012 to April 2019 were enrolled and the incidence of new HCC was retrospectively analyzed. Cox proportional hazards model was used to analyze the risk factors for HCC.Results:Among the 644 patients with chronic HCV infection, 421 cases (65.4%) had chronic hepatitis C(CHC), 223 cases (34.6%) had hepatitis C cirrhosis, and 34 cases had new HCC. No patient without cirrhosis developed HCC. Cox proportional hazards multivariate analysis showed that Child-Pugh grade B or above (hazard ratio ( HR)=6.050, 95% confidence interval ( CI) 2.658 to 13.771, P<0.001), drinking history ( HR=3.077, 95% CI 1.428 to 6.634, P=0.004), family history of cancer ( HR=2.376, 95% CI 1.155 to 4.888, P=0.019), age≥60 years old ( HR=3.301, 95% CI 1.563 to 6.974, P=0.002), controlled attenuation parameter>292 dB/m ( HR=3.842, 95% CI 1.543 to 9.565, P=0.004) were risk factors for HCC. Conclusions:Patients with CHC, especially cirrhosis, are still at risk of HCC post-SVR. HCC monitoring should be strengthened for individuals over 60 years of age, Child-Pugh grade B or above, with severe fatty liver disease, drinking history or family history of malignancy.