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Diabetes enhances hepatocarcinogenesis in noncirrhotic, interferon-treated hepatitis C patients.
- Source :
-
The American journal of medicine [Am J Med] 2010 Oct; Vol. 123 (10), pp. 951-956.e1. - Publication Year :
- 2010
-
Abstract
- Background: This retrospective cohort study assessed the impact of diabetes mellitus on hepatocarcinogenesis and determined the predictors of hepatocarcinogenesis in noncirrhotic, interferon-treated patients with hepatitis C virus infection.<br />Methods: A total of 2058 hepatitis C virus-positive, noncirrhotic patients treated with interferon were enrolled. The median follow-up period was 6.7 years. The primary end point was the onset of hepatocellular carcinoma. The cumulative rate of new hepatocellular carcinoma cases was computed by the Kaplan-Meier method and Cox proportional hazard analysis according to diabetic state and response to interferon therapy.<br />Results: The cumulative rates of hepatocellular carcinoma in diabetic patients (3.2% at 4 years, 8.5% at 8 years, and 24.4% at 12 years) were significantly higher than those of nondiabetic patients (1.3% at 4 years, 2.2% at 8 years, and 5.6% at 12 years, P<.001). In patients with a sustained virologic response, diabetes had no significant effect on the rate of hepatocarcinogenesis. In contrast, the rate in patients with a nonsustained virologic response was significantly higher in diabetic than in nondiabetic patients. Multivariate analysis identified lack of sustained virologic response (hazard ratio [HR] 7.28; 95% confidence interval [CI], 3.28-16.15; P<.001) and diabetes as independent risk factors for hepatocarcinogenesis (HR 2.00; 95% CI, 1.05-3.84; P=.036).<br />Conclusions: Our results highlight the enhancing effect of diabetes mellitus on hepatocarcinogenesis in noncirrhotic, interferon-treated patients with hepatitis C virus. The sustained virologic response induced by interferon therapy eliminates the influence of diabetes and markedly reduces the rate of hepatocarcinogenesis in such patients.<br /> (Copyright © 2010 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Female
Hepatitis C drug therapy
Humans
Interferon-alpha therapeutic use
Interferon-beta therapeutic use
Kaplan-Meier Estimate
Liver pathology
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Retrospective Studies
Ribavirin therapeutic use
Risk Factors
Time Factors
Young Adult
Carcinoma, Hepatocellular etiology
Diabetes Complications complications
Hepatitis C complications
Interferons therapeutic use
Liver Neoplasms etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1555-7162
- Volume :
- 123
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The American journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 20920698
- Full Text :
- https://doi.org/10.1016/j.amjmed.2010.05.013