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Characteristics of elderly hepatitis C virus-associated hepatocellular carcinoma patients
Takashi Kumada1, Hidenori Toyoda, Seiki Kiriyama
1Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan. hosp3@omh.ogaki.gifu.jp
Insights
Elderly patients with hepatitis C virus (HCV) and hepatocellular carcinoma (HCC) often have lower alanine aminotransferase (ALT) levels. Surveillance strategies should consider these factors for optimal care.
Area of Science:
- Hepatology
- Oncology
- Virology
Background:
- The average age of patients diagnosed with hepatocellular carcinoma (HCC) due to hepatitis C virus (HCV) infection is increasing in Japan.
- Understanding the characteristics of older HCV-positive patients who develop HCC is crucial for refining surveillance protocols.
Purpose of the Study:
- To evaluate the clinical and laboratory characteristics of elderly HCV-positive patients who develop HCC.
- To determine an optimal surveillance strategy for this demographic.
Main Methods:
- A cohort of 323 HCV-positive patients with HCC and 323 propensity-matched controls without HCC were analyzed.
- Patients were stratified into four age groups at HCC diagnosis: ≤60, 61-70, 71-80, and >80 years.
- Clinical and laboratory data, including platelet counts and alanine aminotransferase (ALT) levels, were compared across groups.
Main Results:
- Older HCC patients exhibited significantly higher platelet counts and a lower rate of platelet count decline.
- The average integration value of ALT was inversely correlated with age at HCC diagnosis.
- In patients aged ≥65, cirrhosis and ALT levels were associated with hepatocarcinogenesis, but platelet count was not.
Conclusions:
- Elderly HCV-positive individuals (≥65 years) with low ALT values can develop HCC irrespective of their platelet counts.
- Current HCC surveillance protocols may need adjustment to effectively monitor older HCV-positive patients, considering their unique clinical profiles.
Background And Aim:
The average age of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) patients has been rising in Japan. We evaluate characteristics of HCV-positive patients who develop HCC in older age to determine an optimal surveillance strategy.
Methods:
A total of 323 patients with three or more years of follow-up before HCC diagnosis and 323 propensity-matched controls without HCC were studied. HCC patients were classified into four groups according to age at the time of HCC diagnosis: group A (≤ 60 years, n = 36), group B (61-70 years, n = 115), group C (71-80 years, n = 143), and group D (> 80 years, n = 29). Clinical and laboratory data were compared.
Results:
Platelet counts were significantly higher in the older groups at HCC diagnosis (P < 0.0001). The rate of platelet counts decline was lower in older groups (P = 0.0107). The average integration value of serum alanine aminotransferase (ALT) in groups A, B, C, and D were 80.9 IU/L, 62.3 IU/L, 59.0 IU/L, and 44.9 IU/L, respectively (P < 0.0001). In older patients (≥ 65 years old), cirrhosis and average integration value of ALT were significantly associated with hepatocarcinogenesis, but platelet count was not.
Conclusion:
Elderly HCV-positive patients (≥ 65 years old) with low ALT values developed HCC regardless of their platelet counts. These findings should be taken into account when designing the most suitable HCC surveillance protocol for this population.
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