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HEPATOLOGY, VOLUME 60, NUMBER 4 (SUPPL)
AASLD ABSTRACTS
952 Significant Reduction of Hepatocellular Carcinoma Risk in Chronic Hepatitis C Patients with Peg-interferon plus Ribavirin Therapy: A Five-year Clinical Cohort Study Mei-Hsuan Lee1, Yong Yuan2, Ming-Lung Yu3, Wan-Long Chuang3, Jia-Horng Kao4, Chen-Hua Liu4, Sheng-Nan Lu5, I-Shyan Sheen6, Gilbert J. L’Italien2,7, Hwai-I Yang8, Chien-Jen Chen8; 1Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; 2Global Health Economics and Outcome Research, Bristol-Myers Squibb, Princeton, NJ; 3Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital and Kaohsiung Medical University college of Medicine, Kaohsiung, Taiwan; 4Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; 5Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang-Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 6Division of Hepatology, Department of Gastroenterology and Hepatology, Linkou Medical Center, Chang Gung Memorial Hospital, Taipei, Taiwan; 7Yale University School of Medicine, New Haven, CT; 8Genomics Research Center, Academia Sinica, Taipei, Taiwan
Background & Aims: Antiviral therapy may eradicate hepatitis C viral replication, but its long-term impact on the reduction of hepatocellular carcinoma (HCC) remains unclear. This large clinical cohort study aimed to evaluate the predictors of sustained virological response (SVR) and assess the efficacy to reduce HCC post-treatment in Taiwanese chronic hepatitis C patients. Methods: This multicenter study enrolled 1778 anti-HCV-positive patients who were treated with peg-interferon plus ribavirin (PR) for 6-12 months. All of the patients were ^30 years old and seronegative for HBsAg. The treated patients were followed from the date starting PR therapy to the date of HCC diagnosis, death, or the end of 2011, whichever came first. The Cox’s proportional hazards model was utilized to estimate the adjusted hazard ratio and 95% confidence interval associated with HCC by comparing patients with SVR or non-SVR. Results: The mean age of the study patients was 55.4 years, 881 (49.6%) were males, 693 (51.3%) were infected by HCV genotype 1, and 245 (13.8%) had cirrhosis at study entry. There were 1542 (86.7%) patients experienced SVR after receiving treatment. Higher platelet count, lower serum levels of total bilirubin, HCV RNA, and HCV genotype non-1 were independent predictors of achieving SVR. At the 5 years of post-treatment follow-up, there were 49 newly-diagnosed HCC cases (37 with SVR and 12 with non-SVR). The observed 5-year HCC risk was 2.1% for patients with SVR and 4.2% for those with non-SVR, respectively. The cumulative risk of HCC was significantly higher for the non-SVR patients than the SVR patients (p
