Hepatitis C Virus and Hepatocellular Carcinoma

Abstract

In the United States, infection by the hepatitis C virus (HCV) is a major cause of chronic liver disease, and is currently the leading cause for liver transplantation. Also, in many instances, chronic HCV infection may progress to hepatocellular carcinoma (HCC). The incidence of HCC is rising in the U.S., and probably will not reach its peak for another 10 or 20 years. During our earlier studies, we reported that after transfusion associated Hepatitis C in 131 patients, chronic hepatitis (CH), cirrhosis and HCC developed at a mean of 16 years, 20 years and 28 years after exposure, respectively. Also, we noted that patients who were transfused after the age of 50 years had a more rapidly progressive course in that CH, cirrhosis and HCC developed at a mean of 8.5 years, 10 years and 15 years respectively. A similar survey in 125 patients who used intravenous drugs (for 1 year or less) had similar mean progression rates as transfused patients (16 years for CH, 19 years for cirrhosis and 26 years for HCC). In our clinic population, HCC was mainly seen in patients with cirrhosis. In another longitudinal study of 112 patients who presented to our clinic with compensated cirrhosis showed that the annual incidence of decompensation was 4.4%, death from liver disease was 3.4% and development of HCC was 2.4%.