Liver Cancer (Jun 2021)
Impact of Obesity and Heavy Alcohol Consumption on Hepatocellular Carcinoma Development after HCV Eradication with Antivirals
- Tatsuya Minami,
- Ryosuke Tateishi,
- Naoto Fujiwara,
- Ryo Nakagomi,
- Takuma Nakatsuka,
- Masaya Sato,
- Koji Uchino,
- Kenichiro Enooku,
- Hayato Nakagawa,
- Hidetaka Fujinaga,
- Masashi Izumiya,
- Kazuyuki Hanajiri,
- Yoshinari Asaoka,
- Yuji Kondo,
- Yasuo Tanaka,
- Motoyuki Otsuka,
- Takamasa Ohki,
- Masahiro Arai,
- Atsushi Tanaka,
- Kiyomi Yasuda,
- Hideaki Miura,
- Itsuro Ogata,
- Toshiro Kamoshida,
- Kazuaki Inoue,
- Yukihiro Koike,
- Masatoshi Akamatsu,
- Hiroshi Mitsui,
- Hajime Fujie,
- Keiji Ogura,
- Hideo Yoshida,
- Tomonori Wada,
- Kiyohiko Kurai,
- Hisato Maekawa,
- Shuntaro Obi,
- Takuma Teratani,
- Naohiko Masaki,
- Kayo Nagashima,
- Takashi Ishikawa,
- Naoya Kato,
- Kyoji Moriya,
- Hiroshi Yotsuyanagi,
- Kazuhiko Koike
Affiliations
- Tatsuya Minami
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Naoto Fujiwara
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Ryo Nakagomi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Takuma Nakatsuka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Masaya Sato
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Koji Uchino
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Kenichiro Enooku
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Hayato Nakagawa
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Hidetaka Fujinaga
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Masashi Izumiya
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Kazuyuki Hanajiri
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Yoshinari Asaoka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Yuji Kondo
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Yasuo Tanaka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Motoyuki Otsuka
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Takamasa Ohki
- Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan
- Masahiro Arai
- Department of Gastroenterology, Toshiba General Hospital, Toshiba, Japan
- Atsushi Tanaka
- Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
- Kiyomi Yasuda
- Department of Gastroenterology, Kiyokawa Hospital, Tokyo, Japan
- Hideaki Miura
- Department of Gastroenterology, Tokyo Yamate Medical Center, Tokyo, Japan
- Itsuro Ogata
- Department of Gastroenterology, Kawakita General Hospital, Tokyo, Japan
- Toshiro Kamoshida
- Department of Gastroenterology, Hitachi General Hospital, Hitachi, Japan
- Kazuaki Inoue
- Department of Gastroenterology, Showa University Fujigaoka Hospital, Yokohama, Japan
- Yukihiro Koike
- Department of Gastroenterology, Kanto Central Hospital of the Mutual Aid Association of Public School Teacher, Tokyo, Japan
- Masatoshi Akamatsu
- Department of Gastroenterology, JR Tokyo General Hospital, Tokyo, Japan
- Hiroshi Mitsui
- Department of Gastroenterology, Tokyo Teishin Hospital, Tokyo, Japan
- Hajime Fujie
- Department of Gastroenterology, Tokyo Shinjuku Medical Center, Tokyo, Japan
- Keiji Ogura
- Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
- Hideo Yoshida
- Department of Gastroenterology, Japanese Red Cross Medical Center, Tokyo, Japan
- Tomonori Wada
- Department of Gastroenterology, Sanraku Hospital, Tokyo, Japan
- Kiyohiko Kurai
- Kurai Kiyohiko Medical Clinic, Utsunomiya, Japan
- Hisato Maekawa
- Department of Gastroenterology and Hepatology, Tokyo Takanawa Hospital, Tokyo, Japan
- Shuntaro Obi
- Department of Gastroenterology and Hepatology, Kyoundo Hospital, Tokyo, Japan
- Takuma Teratani
- ORCiD
- Department of Hepato-Biliary-Pancreatic medicine, NTT Medical Center Tokyo, Tokyo, Japan
- Naohiko Masaki
- Clinical Laboratory Department, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
- Kayo Nagashima
- Department of Gastroenterology, National Disaster Medical Center, Tachikawa, Japan
- Takashi Ishikawa
- Marunouchi Clinic, Tokyo, Japan
- Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Kyoji Moriya
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Hiroshi Yotsuyanagi
- Division of Infectious Disease and Applied Immunology, The Institute of Medical Science Research Hospital, The University of Tokyo, Tokyo, Japan
- Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Abstract
Background and Aims: It remains unclear whether obesity increases the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C who achieved a sustained virological response (SVR) with antiviral therapy. Methods: In this multicenter cohort study, we enrolled patients with chronic hepatitis C who achieved SVR with interferon (IFN)-based therapy (IFN group) or direct-acting antiviral (DAA) therapy (DAA group) between January 1, 1990, and December 31, 2018. The patients underwent regular surveillance for HCC. Cumulative incidence of and the risk factors for HCC development after SVR were assessed using the Kaplan-Meier method and Cox proportional hazard regression analysis, respectively. Results: Among 2,055 patients (840 in the IFN group and 1,215 in the DAA group), 75 developed HCC (41 in the IFN group and 34 in the DAA group) during the mean observation period of 4.1 years. The incidence rates of HCC at 1, 2, and 3 years were 1.2, 1.9, and 3.0%, respectively. Multivariate analysis revealed that in addition to older age, lower albumin level, lower platelet count, higher alpha-fetoprotein level, and absence of dyslipidemia, obesity (body mass index ≥25 kg/m2) and heavy alcohol consumption (≥60 g/day) were independent risk factors for HCC development, with adjusted hazard ratio (HR) of 2.53 (95% confidence interval [CI]: 1.51–4.25) and 2.56 (95% CI: 1.14–5.75), respectively. The adjusted HR was not significant between the 2 groups (DAA vs. IFN; HR 1.19, 95% CI: 0.61–2.33). Conclusions: Obesity and heavy alcohol consumption increased the risk of HCC development after SVR.
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