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Relationship between infection with hepatitis C virus and hepatocellular carcinoma in Japan
1Department of Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
Insights
Hepatocellular carcinoma (HCC) deaths are rising in Japan, particularly in males due to Hepatitis C Virus (HCV) infection. Sustained normalization of alanine aminotransferase (ALT) levels after interferon (IFN) therapy, regardless of HCV clearance, significantly reduces HCC incidence.
Area of Science:
- Hepatology
- Oncology
- Virology
Background:
- Hepatocellular carcinoma (HCC) mortality is increasing in Japan, with a notable rise in males over the past two decades.
- Hepatitis C Virus (HCV) infection is identified as the primary driver of this increase.
- Interferon (IFN) therapy is a common treatment for HCV, with outcomes monitored by viral clearance and alanine aminotransferase (ALT) levels.
Purpose of the Study:
- To investigate the relationship between interferon therapy outcomes and the incidence of HCC.
- To determine the impact of HCV clearance and ALT normalization on HCC development post-treatment.
- To identify key factors for reducing HCC incidence in treated HCV patients.
Main Methods:
- Retrospective analysis of patients treated with IFN for HCV infection.
- Follow-up duration exceeding 12 months post-treatment.
- Assessment of HCV clearance rates and sustained normalization of ALT levels.
- Correlation analysis between treatment outcomes and subsequent HCC incidence.
Main Results:
- HCV clearance was achieved in 29.8% of patients following IFN therapy.
- Sustained normalization of ALT levels was observed in 41.4% of patients.
- HCC incidence was significantly lower in patients who achieved sustained ALT normalization, irrespective of HCV eradication status.
- IFN's effect on ALT levels was a critical determinant of HCC incidence.
Conclusions:
- Sustained normalization of ALT levels is a crucial factor in reducing HCC incidence after IFN therapy for HCV.
- Future therapeutic strategies should focus not only on HCV eradication but also on managing and lowering ALT levels.
- Controlling ALT levels represents a promising approach to mitigate HCC development in the context of HCV infection.
Abstract:
The number of deaths due to HCC is increasing in Japan. Males in particular have seen a marked increase in the past 20 years, and HCV infection accounts for this increase. In patients treated with IFN and followed up for more than 12 months, HCV clearance was achieved in 29.8% and sustained normalization of ALT levels was achieved in 41.4% following IFN therapy. The incidence of HCC following IFN treatment is dependent on the effect of IFN on ALT levels. The incidence of HCC was low in patients with sustained normalization of ALT levels following IFN therapy, regardless of whether or not HCV had been eradicated. In the future, in addition to the development of therapies to eradicate HCV, treatments to lower ALT levels will also be important.