Steatosis identified as risk factor for liver cancer in HCV-infected patients

Hepatic steatosis appears to be a risk factor for hepatocellular carcinoma (HCC) in patients with chronic hepatitis C virus (HCV) infection, according to a recent report by Japanese investigators.

Multiple factors, including cirrhosis, HCV genotype, and total alcohol intake, have been tied to the risk of developing HCV-associated HCC. Although hepatic steatosis is a common finding in patients with chronic HCV infection, it remains unclear whether this liver abnormality is also risk factor for HCC.The new findings, which are published in the June 15th issue of Cancer, are based on a study of 161 patients who were diagnosed with chronic HCV infection between 1980 and 1999 at Nagasaki University Hospital. All of the patients had no detectable HCC at enrollment. The average follow-up period was 6.4 years.The cumulative incidence rates of HCC at 5, 10, and 15 years after HCV diagnosis were 24%, 51%, and 63%, respectively, senior author Dr. Katsumi Eguchi, from Nagasaki University School of Medicine, and colleagues note. In agreement with previous reports, older age, cirrhosis, and not receiving interferon therapy were identified as independent risk factors for HCC, the authors note. In addition, Dr. Eguchi’s team found that hepatic steatosis was independently linked to an increased risk of HCC (p = 0.0135). Further analysis revealed that this liver abnormality correlated with body mass index and with serum ALT and triglyceride levels.”Our data emphasize the need for the careful monitoring of patients with chronic HCV and hepatic steatosis for the development of HCC,” the researchers state.It is possible that the effects of steatosis on cancer risk may persist even after achieving HCV clearance, Dr. Andrew X. Zhu and Dr. Raymond T. Chung, from Massachusetts General Hospital in Boston, note in a related editorial.”However, before contemplate targeting steatosis as a strategy to decrease the risk of HCC development in patients with chronic HCV infection, it will be important to demonstrate that steatosis is a critical step in the hepatocarcinogenesis pathway,” they add.(Source: Cancer 2003;97:3036-3043,2948-2949: Reuters Health: July 2, 2003: Oncolink)