HCC Rates of Not Reduced by Maintenance Therapy in HALT-C Study

HCC Rates of Not Reduced by Maintenance Therapy in HALT-C Study


"Incidence Rates and Risk Factors Associated with Hepatocellular Carcinoma (HCC) in Patients with Advanced Liver Disease Due to Hepatitis C: Results of the HALTC Trial"



Incidence Rates and Risk Factors Associated with Hepatocellular ...A.S. Lok presented this data at EASL. ... Data regarding HCC imcidence rates and risk factors among patients with HCV-related cirrhosis in the USA are scant ...
www.natap.org/2008/EASL/EASL_51.htm


STUDY AIMS

To determine in the HALT-C Cohort
--the incidence of HCC
--the effect of maintenance interferon therapy on HCC development
--the risk factors associated with HCC development


Cumulative 5 yr incidence of HCC among the HALT-C cohort

-- in the interferon-treated patients and controls was similar: 5.4% vs 5.0% (p=0.78)

-- In patients with cirrhosis was higher than those with bridging fibrosis: 7.0% vs 4.1% (p=0.08)

19% (9/48) of patients with HCC did not show cirrhosis either on baseline or on follow-up biopsies or explant, indicating that the absence of cirrhosis in these patients was not likely to be due to sampling error.

HCC development was significantly associated with older age; lower BMI; platelets and albumn; higher AST, ALT, alkaline phosphate, AFP and DCP; and the presence of esophageal varices.

AUTHOR CONCLUSIONS

Maintenance therapy with low dose peginterferon is ineffective in reducing the development of HCC in patients with advanced liver disease due to HCV.

Modeling of risks can identify patients at highest risk of HCC.

Additional studies are required to confirm our finding of a high risk of HCC in patients with chronic hepatitis C and bridging fibrosis to determine if HCC surveillance is warranted in these patients.