Baseline gamma-glutamyl transferase levels strongly correlate with hepatocellular carcinoma development in non-cirrhotic patients with successful hepatitis C virus eradication

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• 作者：Chung-Feng Huang¹ ; ² ; ³ ; ⁴ ; Ming-Lun Yeh² ; Pei-Chien Tsai² ; Meng-Hsuan Hsieh⁵ ; Hua-Ling Yang² ; Ming-Yen Hsieh² ; ⁷ ; Jeng-Fu Yang⁵ ; Zu-Yau Lin² ; ⁴ ; Shinn-Cherng Chen² ; ⁴ ; Liang-Yen Wang² ; ⁴ ; Chia-Yen Dai¹ ; ² ; ⁴ ; ⁵ ; ^{fish6069@gmail.com" class="auth_mail} ; Jee-Fu Huang² ; ⁴ ; ⁶ ; Wan-Long Chuang² ; ⁴ ; Ming-Lung Yu¹ ; ² ; ⁴ ; ^{fish6069@gmail.com" class="auth_mail}
• 关键词：ALT ; alanine aminotransferase ; AST ; aspartate aminotransferase ; APRI ; the aspartate aminotransferase-to-platelet ratio index ; HCC ; hepatocellular carcinoma ; HCV ; hepatitis C virus ; IL-28B ; interleukin 28B ; 纬GT ; gamma-glutamyl transferase ; SVR ; sustained virological response
• 刊名：Journal of Hepatology
• 出版年：July 2014
• 年：2014
• 卷：61
• 期：1
• 页码：67-74
• 全文大小：870 K

文摘

Hepatitis C virus (HCV)-infected patients with cirrhosis remain at risk of hepatocellular carcinoma (HCC) even after achieving sustained virological response (SVR). The aim of the study was to explore the incidence and risk for HCC among non-cirrhotic patients with an SVR.

Methods

A total of 642 patients with an SVR after peginterferon/ribavirin therapy were enrolled with a median follow-up period of 53.0 months (range: 6–133 months).

Results

Thirty-three of the 642 (5.1%) patients developed HCC over 2324.8 person-years of follow-up. Cox regression analysis revealed that the strongest predictive factor of HCC occurrence was liver cirrhosis (HR 4.98, 95% CI 2.32–10.71, p <0.001), followed by age (HR 1.06, 95% CI 1.02–1.11, p = 0.005) and 纬GT levels (HR 1.008, 95% CI 1.004–1.013, p <0.001). The incidence of HCC did not differ between patients with high and low baseline 纬GT levels among patients with cirrhosis (p = 0.53), but the incidence of HCC was significantly higher in non-cirrhotic patients with high 纬GT levels compared with those with low 纬GT levels (p = 0.001). Cox regression analysis revealed that the strongest factors associated with HCC development in non-cirrhotic sustained responders were baseline 纬GT levels (HR 6.44, 95% CI 2.20–18.89, p = 0.001) and age (HR 3.68, 95% CI 1.33–10.17, p = 0.012). The incidence of HCC was not different between older non-cirrhotic patients with high 纬GT levels and cirrhotic patients (p = 0.34).

Conclusions

HCC remains a threat in non-cirrhotic patients with an SVR. Serum 纬GT levels helped to identify potential patients at high risk.