Comparison of the Incidence of Hepatocellular Carcinoma in HBV-and HCV-associated Liver Cirrhosis: A Prospective Study

Lee, Hyo Suk; Lee, Jun Haeng; Choi, Moon Suk; Kim, Chung Yong

Abstract

OBJECTIVES
patients with HCV-associated liver cirrhosis had greater risk of hepatocellular carcinoma(HCC) than patients with HRV-associated in areas pirevalent for HCV infection. However, the relative risks of. HBV and HCV for HCC have not been investgated in an HBV-endemic area. The piresent study was designed to study prospectively the relative risk of HBV and HCV for HCC In korea. An HBV- endemic, area.
METHODS
We enrolled 373 patien ts with liver ciirrhosis who had experienced thc esophageal variccal bleeding and had been treated by endoscopic injection sclerothenpy, and survived more than 3 months. They were devided into three grourp 1) 245( 65.7%) patients who were positive for HBsAg but nagative for anti- HCV were in HBV group 2) 48 (l2.9'% ) who were negative for HBsAg but positive for anti-H C V were HCV group, and, 3)80 (21.4%) were negative for both were NBNC group. The duta were analyzed stalistically using Kaplan-Melermethod and COX proportional-hazzards regression analysis.
RESULTS
During the mean follow-up period of 3.4 years. 68(18.2 %) patients developed HCC. The cumulattive incidence of HCC. Among all patients was 25.4 % during the first 5 years: the incidences in each HBV. HCV and NBNC group during, the first 3 years were 18.3%, 22.0%, and 5.6%. Respectively and those during the first 6 years were 34.7%, 54.8%, and l7.0%, respectively. By univeriate analysis age older than 50 yearser and initial serum a-PF level higher than 5ng/ml also appered to be predictors of grealer risk for the development of HCC. By multivarite analysis. HlBsA g positivity, anti-HCV positivily, old age, and male sex were independent risk factors for HCC.
CONCLUSION
We showed for the first time by a prospective study that anti-HCV positive cirrhotic patients had no less or even greater risk I or the development of HCC. Than HBsAg-positive paticnl seven in in HBV-endemic korea as they had in HCV-endemic area such as Japan and Italy.