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. 2016:2016:7476231.
doi: 10.1155/2016/7476231. Epub 2016 Aug 30.

Clinical Impact of Viral Load on the Development of Hepatocellular Carcinoma and Liver-Related Mortality in Patients with Hepatitis C Virus Infection

Ran Noh  1 , Doo Hyuck Lee  1 , Byoung Woon Kwon  1 , Yong Hyun Kim  1 , Suk Bae Kim  1 , Il Han Song  1
Affiliations

Clinical Impact of Viral Load on the Development of Hepatocellular Carcinoma and Liver-Related Mortality in Patients with Hepatitis C Virus Infection

Ran Noh et al. Gastroenterol Res Pract. 2016.

Abstract

Aim. This study aimed to assess clinical impact of hepatitis C viral load on the development of hepatocellular carcinoma (HCC) and liver-related mortality in HCV-infected patients. Methods. A total of 111 subjects with chronic HCV infection who were available for serum quantitation of HCV RNA were recruited in this retrospective cohort. Cox-proportional hazards models were used to calculate hazard ratio (HR) of developing HCC and liver-related mortality according to serum HCV RNA titers. Results. HCC was developed in 14 patients during follow-up period. The cumulative risk of HCC development was higher in subjects with high HCV RNA titer (log HCV RNA IU/mL > 6) than subjects with low titer (log HCV RNA IU/mL ≦ 6) (HR = 4.63, P = 0.032), giving an incidence rate of 474.1 and 111.5 per 10,000 person-years, respectively. Old age (HR = 9.71, P = 0.014), accompanying cirrhosis (HR = 19.34, P = 0.004), and low platelet count (HR = 13.97, P = 0.009) were other independent risk factors for the development of HCC. Liver-related death occurred in 7 patients. Accompanying cirrhosis (HR = 6.13, P = 0.012) and low albumin level (HR = 9.17, P = 0.002), but not HCV RNA titer, were significant risk factors related to liver-related mortality. Conclusion. Serum HCV RNA titer may be considered an independent risk factor for the development of HCC but not liver-related mortality.

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Figures

Figure 1
Figure 1
Schematic flow of the recruitment of study participants.
Figure 2
Figure 2
Cumulative incidence of hepatocellular carcinoma according to the viral load of serum HCV RNA. The cumulative incidence rate of HCC in patients with high viral load (log HCV RNA IU/mL > 6) was significantly higher than that in patients with low viral load (log HCV RNA IU/mL ≦ 6) (P = 0.032).
Figure 3
Figure 3
Cumulative liver-related mortality according to the viral load of serum HCV RNA. No significant difference of cumulative liver-related mortality was seen in patients with high or low viral load (P = 0.675).
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