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.