Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2000 Jul;47(1):131-6.
doi: 10.1136/gut.47.1.131.

Hepatitis C virus related cirrhosis: time to occurrence of hepatocellular carcinoma and death

F Degos  1 , C Christidis, N Ganne-Carrie, J P Farmachidi, C Degott, C Guettier, J C Trinchet, M Beaugrand, S Chevret
Affiliations
Multicenter Study

Hepatitis C virus related cirrhosis: time to occurrence of hepatocellular carcinoma and death

F Degos et al. Gut. 2000 Jul.

Abstract

Background: In patients with hepatitis C virus (HCV) infection and cirrhosis, long term outcome and the incidence of hepatocellular carcinoma (HCC) are still debated.

Design: From January 1987 to January 1997, 416 patients (240 male, median age 57 years) with uncomplicated Child-Pugh A HCV related cirrhosis were followed in two Paris area centres from diagnosis of cirrhosis until death or reference date (1 June 1998). The analysis used a three state disability model generalising the Cox model.

Results: Of the 416 patients, 60 developed HCC with a five year rate of 13.4% (95% confidence interval (CI) 9.0-17.8%) and 83 died (including 34 with HCC), with a five year death rate of 15.3% (95% CI 12.6-18.0%). By multivariable analysis, time to HCC relied on age (hazard ratio (HR) 1.05 per year; p=0.0005), male sex (HR 2.13; p=0.01), oesophageal varices (HR 2.36; p= 0.008), decreased platelet count (HR 0.99; p=0. 03), and bilirubin level (HR 1.01; p=0.003), while death after HCC was mainly related to tobacco consumption (HR 1.04; p=0.0006). In contrast, death free of HCC was dependent on age (HR 1.04; p=0.01), oesophageal varices (HR 2.75; p=0.001), low platelet count (HR 0.99; p=0.006), and albumin level (HR 0.90; p=0.0001).

Conclusion: The incidence of HCC and mortality should be higher in these patients than previously stated, and prognostic factors of HCC and death are closely related age and symptoms of portal hypertension.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Three state disability model. Each box refers to one state (cirrhosis, hepatocellular carcinoma, or death), while arrows denote possible transitions between these states.
Figure 2
Figure 2
Estimated time to outcome (hepatocellular carcinoma (HCC), death after HCC, or death free of HCC) with associated estimated hazard of developing the event over one year time intervals. This refers to the conditional failure rate (that is, the probability of an individual free of an event at the end of the time interval experiencing the event in the next interval). An interesting feature of these data is that the hazard rate for HCC increases over time while the hazard rates for death remain roughly constant over time.
Figure 3
Figure 3
Estimated time to hepatocellular carcinoma (HCC) according to serum α fetoprotein (AFP) levels (± 20 ng/ml) and large cell dysplasia.
See this image and copyright information in PMC

References

    1. Hepatology. 1996 May;23(5):1112-8 - PubMed
    1. Lancet. 1995 Oct 21;346(8982):1051-5 - PubMed
    1. J Hepatol. 1996;24(2 Suppl):61-6 - PubMed
    1. J Hepatol. 1996 Feb;24(2):141-7 - PubMed
    1. Gastroenterology. 1997 Feb;112(2):463-72 - PubMed

Publication types

MeSH terms