Effect of Aging on Risk for Hepatocellular Carcinoma in Chronic Hepatitis C Virus Infection

Yasuhiro ASAHINA; Kaoru TSUCHIYA; Hiroyuki NAKANISHI; Jun ITAKURA; Yuka TAKAHASHI; Masayuki KUROSAKI; Nobuyuki ENOMOTO; Namiki IZUMI; Nobuharu TAMAKI; Itsuko HIRAYAMA; Tomohiro TANAKA; Mitsuaki SATO; Yutaka YASUI; Takanori HOSOKAWA; Ken UEDA; Teiji KUZUYA

doi:10.1002/hep.23691

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Effect of Aging on Risk for Hepatocellular Carcinoma in Chronic Hepatitis C Virus Infection

Journal article

Open access

Peer reviewed

Effect of Aging on Risk for Hepatocellular Carcinoma in Chronic Hepatitis C Virus Infection

Yasuhiro ASAHINA, Kaoru TSUCHIYA, Hiroyuki NAKANISHI, Jun ITAKURA, Yuka TAKAHASHI, Masayuki KUROSAKI, Nobuyuki ENOMOTO, Namiki IZUMI, Nobuharu TAMAKI, Itsuko HIRAYAMA, …

Hepatology (Baltimore, Md.), Vol.52(2), pp.518-527

2010

DOI: 10.1002/hep.23691

PMID: 20683951

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Abstract

An increase in the aging population is an impending problem. A large cohort study was carried out to determine the influence of aging and other factors on hepatocarcinogenesis in patients treated with interferon. Biopsy-proven 2547 chronic hepatitis C patients registered at our referral center since 1992 were included. Of these, 2166 were treated with interferon-based therapy. Incidences of hepatocellular carcinoma (HCC) associated with interferon were analyzed by Kaplan-Meier and person-years methods for an average follow-up of 7.5 years. Factors associated with HCC risk were determined by Cox proportional hazard analysis. HCC developed in 177 interferon-treated patients. The risk for HCC depended on age at primary biopsy and increased more than 15-fold after 65 years of age. Even when stratified by stage of fibrosis, the cumulative and annual incidences of HCC were significantly higher in older patients than in younger patients (P < 0.001) at the same stage of fibrosis, except for cirrhosis. Progression of fibrosis over time was significantly accelerated in older patients. The impact of viral eradication on HCC prevention was less significant in older patients than in younger patients. Multivariate analysis confirmed that age, gender, liver fibrosis, liver steatosis, total cholesterol level, fasting blood sugar level, baseline and postinterferon alpha-fetoprotein level, and virological response to interferon were independent risk factors associated with HCC. Aging was the strongest risk factor for a nonvirological response to interferon-based antiviral therapy. Conclusion: Elderly patients are at a higher risk for HCC. Hepatitis C viral eradication had a smaller effect on hepatocarcinogenesis in older patients. Patients should therefore be identified at an earlier age and treatment should be initiated.

Infectious Diseases

Tumors

Gastroenterology. Liver. Pancreas. Abdomen

Viral hepatitis

Liver. Biliary tract. Portal circulation. Exocrine pancreas

Viral diseases

Biological and medical sciences

Medical sciences

Human viral diseases

Details

Title: Subtitle: Effect of Aging on Risk for Hepatocellular Carcinoma in Chronic Hepatitis C Virus Infection
Creators: Yasuhiro ASAHINA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Kaoru TSUCHIYA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Hiroyuki NAKANISHI - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Jun ITAKURA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Yuka TAKAHASHI - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Masayuki KUROSAKI - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Nobuyuki ENOMOTO - First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
Namiki IZUMI - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Nobuharu TAMAKI - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Itsuko HIRAYAMA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Tomohiro TANAKA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Mitsuaki SATO - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Yutaka YASUI - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Takanori HOSOKAWA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Ken UEDA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Teiji KUZUYA - Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
Resource Type: Journal article
Publication Details: Hepatology (Baltimore, Md.), Vol.52(2), pp.518-527
DOI: 10.1002/hep.23691
PMID: 20683951
NLM abbreviation: Hepatology
ISSN: 0270-9139
eISSN: 1527-3350
Publisher: Wiley
Language: English
Date published: 2010
Academic Unit: Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9984094546502771

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