Background/Aims
This study sought to identify the independent risk factors involved in the development
of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C virus (HCV)
infection who have normal alanine aminotransferase (ALT) levels.
Methods
A total of 519 patients with average ALT integration values less than or equal to
40 IU/L over 10 years were included. Baseline ultrasound was done in all patients
and 68 patients underwent liver biopsy at the start of this study. Factors associated
with the cumulative incidence of HCC were determined.
Results
HCC occurred in 48 of 519 patients (9.2%). The following factors were significantly
associated with the incidence of HCC: age > 65 years (adjusted hazard ratio: 2.006 [95% confidence interval: 1.078–3.733]), ALT > 20 IU/L (6.242 [1.499–25.987]), platelet count < 15.0 × 104/m3 (2.675 [1.407–5.085]), total bilirubin > 1.2 mg/dL (2.798 [1.257–6.228]), ALP > 338 IU/L (2.486 [1.327–4.657]), and total albumin < 3.5 g/dl (2.707 [1.177–6.223]). The 5- and 10-year cumulative incidences of HCC were 4.4%
and 26.5% in patients with ALT > 20 IU/L and platelet count < 15.0 × 104/m3, respectively.
Conclusions
High ALT level and low platelet count are closely associated with the development
of hepatocarcinogenesis. Therefore, individuals within this group are candidates for
antiviral therapy.
Keywords
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Article info
Publication history
Published online: January 06, 2009
Accepted:
November 8,
2008
Received in revised form:
November 3,
2008
Received:
July 23,
2008
Associate Editor: K. KoikeFootnotes
☆The authors declare that they do not have anything to disclose regarding funding from industries or conflict of interest with respect to this manuscript.
Identification
Copyright
© 2008 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
