The Role of Hepatitis C Virus in Hepatocellular Carcinoma in Japan

Kaneko, Shuichi; Unoura, Masashi; Takeuchi, Masayu; Terasaki, Shuichi; Ogino, Hidero; Matsushita, Eiki; Kobayashi, Kenichi

doi:10.1159/000150364

Cited by 18 publications

(10 citation statements)

References 5 publications

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“…Among the other risk factors we identified for the development of HCC, a low platelet count stands out. The platelet count is a useful marker for the diagnosis of cirrhosis [28], and cirrhosis is an established risk factor for HCC in HCV carriers [26,[28][29][30]. Taken together with our other findings, the low platelet count suggests that HCC develops in patients with progressive or advanced liver disease.…”

Section: Discussionsupporting

confidence: 75%

Predictive value of tumor markers for hepatocarcinogenesis in patients with hepatitis C virus

et al. 2010

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Section: Discussionsupporting

confidence: 75%

Predictive value of tumor markers for hepatocarcinogenesis in patients with hepatitis C virus

et al. 2010

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“…As a large proportion of HCCs develop from LC, especially from those associated with viral infection [20,21], patients with HCV-LC have a high risk of HCC and, indeed, HCC develops in 6-8% of all HCV-LC cases every year in Japan [14,[22][23][24]. Preventing the development of HCC in these patients is therefore very important.…”

Section: Discussionmentioning

confidence: 99%

Close Association between High Serum ALT and More Rapid Recurrence of Hepatocellular Carcinoma in Hepatectomized Patients with HCV-Associated Liver Cirrhosis and Hepatocellular Carcinoma

et al. 2000

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We investigated whether or not a high serum alanine aminotransferase (ALT) level is associated with a more rapid recurrence of hepatocellular carcinoma (HCC) in hepatectomized patients with hepatitis C virus (HCV)-associated liver cirrhosis (LC) (HCV-LC) and HCC. Thirty-three hepatectomized patients with HCV-LC and HCC of a single nodule who had no histologic evidence of portal or hepatic vein invasion and who had been followed up for more than 3 years were included in the study. They were subdivided into two groups according to their serum ALT levels, ALT being a well-known marker of inflammatory necrosis in the liver. Seventeen patients whose serum ALT levels showed several peaks or plateaus above 80 international units (IU) were designated as the high ALT group, and 16 patients whose serum ALT levels showed a sustained low level below 80 IU until the first recurrence were designated as the low ALT group, and the interval between hepatectomy and the first recurrence was observed. In the high ALT group, HCC recurred within 3 years in 70.6% of the patients. In contrast, it recurred in only 18.8% of the low ALT group within the same period (p < 0.05). There was a significant difference (p = 0.0201) between the two groups in the cumulative nonrecurrence rate. The mean interval in recurrent patients between hepatectomy and the first recurrence in the high ALT group (23.6 ± 2.8 months; mean ± SE) was significantly (p < 0.02) shorter than that in the low ALT group (49.3 ± 9.7 months). The expected interval between hepatectomy and recurrence was as short as 2.8 ± 0.5 years (mean ± SE) in the high ALT group, compared with 5.8 ± 0.7 years in the low ALT group (p < 0.05). These results showed that the recurrence of HCC was accelerated in the high ALT group, suggesting that suppression of the rise in ALT level after hepatectomy by treatment with anti-inflammatory drugs may prolong the interval until recurrence by about 2 years in hepatectomized patients with HCC and HCV-LC.

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“…2). The Markov model begins with an initial clinical state (chronic hepatitis C) and the patients could remain in the same state or move to the next state, Transition probabilities were estimated by the previously reported sources (Ikeda et al 1993;Takahashi et al 1993;Kaneko et al 1994;Kato et al 1994;Nishiguchi et al 1995;Miyakawa et al 1996;Yano et al 1996;Serfaty et al 1998;Shibata et al 1998;Tanaka et al 1998;Benvegnu et al 2004;Planas et al 2004;Ikai et al 2006;Trevisani et al 2007). Probable ranges of the transition probabilities were based on their 95% confidence intervals.…”

Section: Markov Modelmentioning

confidence: 99%

Cost-Effectiveness of the National Screening Program for Hepatitis C Virus in the General Population and the High-Risk Groups

Nakamura

Terajima

Aoyagi

et al. 2008

Tohoku J. Exp. Med.

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In Japan, the national screening for the hepatitis C virus (HCV) has been started for both the general population and the high-risk groups. Our cost-effectiveness analysis was based on the result of the screening program including 99,001 people among the general population and 42,538 people among the high risk group from 2003 to 2006. The screening was performed using the three steps of the semi-quantitative HCV antibody test, the HCV core antigen test and the HCV-PCR test. A Markov model for HCV infected patients was constructed to estimate the future clinical benefits and the lifetime cost and the cost-effectiveness analysis was performed considering the recent treatment with peginterferon plus ribavirin. In the cost-effectiveness analysis, the cohort, in which the screening was implemented (= screening strategy), was compared with the similar cohort without the screening (= no-screening strategy) in both the general population and the high-risk group, stratified by age. The infection rates of the general population and the high-risk group were 0.36% and 0.81%, respectively. The incremental cost-effectiveness ratio (ICER), a measure of cost-effectiveness, of the general population and the high-risk group was calculated to be from 848 to 4,825 and -749 to 2,297 $/life expectancy gained, respectively. The treatment effectiveness, transition probabilities and the infection rate varied in the one-way sensitivity analyses, but the superiority of the screening strategy regarding the cost-effectiveness was unchanged. In conclusion, the screening strategy in both the general population and the high-risk group therefore appears to be more cost-effective than a no-screening strategy.screening; hepatitis C; general population; high risk group; cost-effectiveness. Tohoku

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The Role of Hepatitis C Virus in Hepatocellular Carcinoma in Japan

Cited by 18 publications

References 5 publications

Predictive value of tumor markers for hepatocarcinogenesis in patients with hepatitis C virus

Predictive value of tumor markers for hepatocarcinogenesis in patients with hepatitis C virus

Close Association between High Serum ALT and More Rapid Recurrence of Hepatocellular Carcinoma in Hepatectomized Patients with HCV-Associated Liver Cirrhosis and Hepatocellular Carcinoma

Cost-Effectiveness of the National Screening Program for Hepatitis C Virus in the General Population and the High-Risk Groups

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