Skip to main content

Advertisement

Table 2 Host and viral risk factors for post-sustained virologic response (SVR) hepatocellular carcinoma (HCC) development (summarized from multivariable Cox regression models)

From: Hepatitis C-related hepatocellular carcinoma in the era of new generation antivirals

Risk factor   Variable n Country Follow-up, median, years Hazard ratio 95% CI P value Reference
Host factor Fibrosis         
  Pre-SVR         
   Histological stage F2-4 562 Japan 4.8 10.7 2.2–192.1 <0.001 [53]
   Histological stage, F3-4 1273 Japan 1.1 9.0 2.3–35.2 0.002 [34]
   Histological stage, F3-4 1094 Japan 4.2 3.2 1.6–7.2 <0.001 [58]
   Histological stage, F3-4 376 Taiwan 7.6 12.8 1.6–101.9 0.021 [56]
   Histological stage, F3-4 871 Taiwan 3.4 4.0 1.5–10.7 0.007 [51]
   Platelet, < 150 × 103/mm3 1056 Japan 4.7 2.8 1.1–7.2 0.04 [68]
   Platelet, < 150 × 103/mm3 871 Taiwan 3.4 2.8 1.2–6.4 0.015 [51]
   Platelet, < 150 × 103/mm3 1000 Europe and Canada 5.7 1.1 1.0–1.1 0.029 [61]
   Albumin, < 35 g/dL 399 Sweden 7.8 4.4 1.3–14.7 0.016 [69]
   Liver cirrhosis, yes 1351 Taiwan 4.0 8.4 4.1–17.0 <0.001 [70]
   Liver cirrhosis, yes 4663 Canada 5.6 3.2 1.2–9.0 [71]
  Post-SVR         
   FIB-4 index, high 522 Japan 7.2 1.7 1.1–2.9 0.02 [55]
   APRI ≥ 0.7 1351 Taiwan 4.0 2.9 1.5–5.7 0.002 [70]
   Elastography liver stiffness > 12 kPa 376 Taiwan 7.6 6.3 2.1–19.5 0.001 [56]
   Liver cirrhosis, yes 10,738 USA 2.8 6.7 4.3–10.4 <0.001 [36]
   Platelet, < 130 × 103/mm3 571 Japan 9.0 3.9 1.5–10.1 0.004 [72]
  Age, years ≥50 562 Japan 4.8 4.1 1.4–17.4 <0.01 [53]
   ≥55 571 Japan 9.0 3.6 1.4–9.6 0.009 [72]
   ≥60 642 Taiwan 4.4 3.7 1.3–10.2 0.012 [52]
   ≥60 871 Taiwan 3.4 3.8 1.7–8.4 0.001 [51]
   ≥60 4663 Canada 5.6 4.4 1.3–15.3 [71]
   >60 1094 Japan 4.2 3.1 1.3–6.6 0.009 [58]
   >60 1056 Japan 4.7 3.1 1.3–7.4 0.01 [68]
   >60 1000 Europe and Canada 5.7 9.8 1.2–77.8 0.031 [61]
   ≥65 1425 Japan 3.3 5.8 1.1–30.1 0.036 [54]
   ≥65 1351 Taiwan 4.0 2.7 1.2–6.3 0.017 [70]
   ≥65 10,738 USA 2.8 4.5 2.0–10.4 <0.001 [36]
   Older 589 Taiwan 4.7 1.1 1.0–1.1 0.046 [73]
  Sex Male 1094 Japan 4.2 12.0 2.8–50.0 <0.001 [58]
   Male 4663 Canada 5.6 3.3 1.1–9.6 [71]
   Male 571 Japan 9.0 7.6 1.7–33.1 0.007 [72]
  Diabetes Yes 522 Japan 7.2 2.1 1.1–4.0 0.045 [55]
   Yes 376 Taiwan 7.6 4.0 1.3–12.1 0.021 [56]
   Yes 399 Sweden 7.8 3.2 1.1–9.6 0.035 [69]
   Yes 10,738 USA 2.8 1.9 1.2–2.9 0.005 [36]
   Yes 1000 Europe and Canada 5.7 2.3 1.0–5.3 0.057 [61]
   Yes 4663 Canada 5.6 1.6 0.6–4.0 [71]
   Yes 589 Taiwan 4.7 3.8 1.4–10.1 0.008 [73]
  Elixhauser comorbidity index Yes (≥1) 4663 Canada 5.6 2.2 1.0–5.1 [71]
  Alpha-fetoprotein, ng/mL         
  Pre-SVR ≥8 562 Japan 4.8 2.6 1.2–6.1 <0.05 [53]
   ≥15 1351 Taiwan 4.0 1.9 1.0–3.6 0.038 [70]
   ≥20 871 Taiwan 3.4 3.2 1.6–6.2 0.001 [51]
  Post-SVR ≥5 1425 Japan 3.3 8.1 2.7–23.9 <0.001 [54]
   ≥5 571 Japan 9.0 3.6 1.4–9.6 0.009 [72]
   ≥15 1351 Taiwan 4.0 2.3 1.0–5.3 0.043 [70]
   ≥10 1094 Japan 4.2 7.8 2.9–16.8 <0.001 [58]
  Race/ethnicity Hispanic 10,738 USA 2.8 2.3 1.1–4.8 0.032 [36]
  Alcohol abuse Yes 562 Japan 4.8 3.9 1.7–9.0 <0.01 [53]
   Yes 10,738 USA 2.8 1.7 1.1–2.6 0.021 [36]
   Yes 4663 Canada 5.6 1.1 0.34–3.3 [71]
  Illicit drug use Yes 4663 Canada 5.6 3.7 1.0–14.3 [71]
  AST >100 IU/L 1056 Japan 4.7 3.1 1.3–7.3 0.01 [68]
  AST/ALT ratio >0.72 1000 Europe and Canada 5.7 1.0 1.0–1.1 0.068 [61]
  GGT >75 U/L 642 Taiwan 4.4 6.4 2.2–18.9 0.001 [52]
Viral factor Genotype 1b with Gln70 (His70) variant   1273 Japan 1.1 10.5 2.9–38.2 <0.001 [34]
  Genotype 3   10,738 USA 2.8 1.6 1.0–2.7 0.071 [36]
  Genotype 3   4663 Canada 5.6 1.4 0.58–3.4 [71]
  1. All data are from interferon-based studies
  2. APRI aspartate aminotransferase-to-platelet ratio index, ALT alanine aminotransferase, AST aspartate aminotransferase, FIB-4 fibrosis-4, GGT gamma-glutamyl transpeptidase, HCV hepatitis C virus, HCC hepatocellular carcinoma, SVR sustained virologic response