Author information
1Department of Hepatology, Beaujon Hospital, AP-HP, Clichy, France; INSERM U1137, University Paris 7, UFR of Medicine, France; INSERM U1149/CRI, Beaujon Hospital, AP-HP, Clichy, France. Electronic address: blaise.kutala@bjn.aphp.fr.
2Department of Pathology, Beaujon Hospital, AP-HP, Clichy, France.
3INSERM U1137, University Paris 7, UFR of Medicine, France.
4Department of Hepatology, Beaujon Hospital, AP-HP, Clichy, France; INSERM U1149/CRI, Beaujon Hospital, AP-HP, Clichy, France.
5INSERM U1149/CRI, Beaujon Hospital, AP-HP, Clichy, France.
Abstract
BACKGROUND:
There are very few studies on the incidence and risk factors of hepatitis C virus (HCV)-induced hepatocellular carcinoma (HCC) in the absence of advanced fibrosis. Our objective was to identify the clinical-pathological features of these patients.
METHODS:
We retrospectively reviewed 162 patients admitted to our hospital for HCV-related HCC between 2000 and 2010. Patients with hepatitis of other aetiologies, human immunodeficiency virus co-infection, or treated with interferon were excluded. We compared demographic, laboratory, clinical and outcome parameters of patients with and without advanced fibrosis.
RESULTS:
137 patients had advanced fibrosis (85%). Median age was higher in the advanced fibrosis vs. the non-advanced fibrosis group (62 vs. 65 years, respectively; p=0.025). Steatosis was significantly more frequent in patients with advanced fibrosis compared to those without advanced fibrosis (43% vs. 20%, respectively; p=0.032). Independent predictors associated to the occurrence of HCC in patients without advanced fibrosis were hepatitis B core antigen (odds ratio: 3.86; p=0.044) and duration of hepatitis C infection (odds ratio: 1.21; p=0.003).
CONCLUSIONS:
Risk factors such as steatosis or diabetes were not frequent in patients without advanced fibrosis. Further studies are needed to evaluate the role of occult hepatitis B and the duration of hepatitis infection in patients with HCC and chronic hepatitis C without advanced fibrosis.