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Reduction therapy of alanine aminotransferase levels prevent HCC development in patients with HCV-associated cirrhosis.

Author(s): Rino Y, Tarao K, Morinaga S, Ohkawa S, Miyakawa K, Hirokawa S, Masaki T, Tarao N, Yukawa N, Saeki H, Takanashi Y, Imada T

Affiliation(s): Department of Surgery, Yokohama City University, School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. rino@med.yokohama-cu.ac.jp

Publication date & source: 2006-05, Anticancer Res., 26(3B):2221-6.

Publication type: Research Support, Non-U.S. Gov't

BACKGROUND: To find a way to prevent the development of hepatocellular carcinoma (HCC) from hepatitis C virus-associated liver cirrhosis (HCV-LC), an analysis of the HCV-LC patients who had received reduction therapy of the alanine aminotransferase (ALT) levels was performed. PATIENTS AND METHODS: Seventy-four consecutive HCV-LC patients of Child Stage A were followed for >10 years for the development of HCC. They were divided into two groups: in group A, the reduction therapy for the ALT levels was aggressively performed, while in group B, the reduction therapy was not performed aggressively. The patients were subdivided into three sub-groups according to their serum ALT levels. In groups A and B, the high ALT group was comprised, respectively, of nine and five patients whose annual average serum ALT levels were persistently high (> or =80 IU), while the low ALT group was comprised of 19 and 20 patients whose annual average serum ALT levels were persistently low (<80 IU). The remaining eleven and ten patients had annual average serum ALT levels which fluctuated and were unclassified (unclassified group). RESULTS: In group B, 65.7% of the patients had developed HCC in 13 years, in contrast to only 41.0% of group A (p=0.039). In group A, the median HCC development time was 12.8 years, in contrast to only 3.8 years in group B (p=0.0013). Multivariate analysis demonstrated that the mode of reduction therapy and ALT levels were the significant factors affecting HCC development. CONCLUSION: The chances of surviving for more than ten years without developing HCC for HCV-LC patients

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