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Age at infection of Hepatitis C virus and risk of hepatocellular
carcinoma in cirrhosis
T. Suou, H. Tanaka, A. Mitsuda, K. Miura, T. Yamamoto, H. Kawasaki Japan
The aim of this study was to assess whether the age at the time of Hepatitis
C virus (HCV) infection was associated with an increased risk of hepatocellular
carcinoma (HCC) after the infection. A total of 139 patients with HCV-related
cirrhosis and a history of a blood transfusion were evaluated for the
development of HCC after the time of blood transfusion.
Multivariant regression analysis of the study results showed that the
age at transfusion was the most important risk factor associated with
the development of HCC after the initial blood transfusion (odds ratio
6.03, p  0.0001). Other independent risk factors
were the age at the diagnosis of cirrhosis (odds ratio 3.23, p 0.01) and male sex (odds ratio 2.22, p 0.05), although HCV genotype, HCV
RNA level, alcohol intake and smoking were not related the carcinogenesis.
The mean age of the patients was 61 years (range, 35 to 84) at the time
of diagnosis. The mean age at the time of blood transfusion was 36 years
(range, 7 to 69), and the mean interval between the time of blood transfusion
and the diagnosis of cirrhosis was 25 years (range, 5 to 50). The interval
correlated negatively with the age at transfusion (r = -0.645, p 0.0001) and positively
with the age at diagnosis (r = 0.356, p 0.0001). After a 5.4 year
follow up, HCC developed in 54 (39 per cent) of the patients.
The Japanese team suggests that HCV infection in old patients induces
a rapid progression to HCC independent of HCV genotype.
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