Background: In many countries, including Sweden, the birth cohorts with the highest prevalence of hepatitis C virus (HCV) infection have now reached the ages with high risk of primary liver cancer (PLC). The aims of this study were to investigate the temporal trends in PLC incidence and the relative risks of PLC among people diagnosed with HCV infection between 1990 and 2015.
Methods: The HCV cohort (n = 52,853) was compared with a matched non-HCV comparison cohort (n = 523,649). Both the national Cancer Register (CR) and Cause of Death Register (DR) were used for follow-up. The crude and age-standardized PLC incidence rates were calculated. The relative risk was estimated as standardized incidence ratios (SIR) and as HRs using stratified Cox hazards regression.
Results: There were 1,609 with PLC diagnosis in the HCV cohort; the annual number increased continuously with the crude incidence rate reaching 4.56 per 1,000 person-years in 2013 while remaining low and stable in the comparison cohort. In the HCV cohort, the age-standardized PLC incidence rates per 1,000 person-years remained relatively constant at 2.64 [95% confidence interval (CI), 1.54-3.75] in 2000 and 3.31 (2.51-4.12) in 2014. The highest SIR was 73 (65.9-79.5) among those infected for 35 to 40 years; and the highest HR was 65.9 (55.9-77.6) for men and 62.2 (31.9-121.1) for women.
Conclusions: There was a considerable increase in PLC incidence over time and an extremely high relative risk in the population with HCV infection for more than 35 years.
Impact: The national HCV-associated PLC incidence should be monitored in future studies to evaluate the effect of direct-acting antiviral (DAA) treatment.
©2019 American Association for Cancer Research.
Hepatocellular Carcinoma and Other Primary Liver Cancers in Hepatitis C Patients in Sweden - A Low Endemic CountryR Strauss et al. J Viral Hepat 15 (7), 531-7. PMID 18397224.The aim of this study was to assess the risk of hepatocellular carcinoma (HCC) and other primary liver cancers (PLC) in the nationwide cohort of hepatitis C virus (HCV) i …
Herbal Medicine Containing Aristolochic Acid and the Risk of Primary Liver Cancer in Patients With Hepatitis C Virus InfectionCJ Chen et al. Cancer Epidemiol Biomarkers Prev 28 (11), 1876-1883. PMID 31409611.The current findings suggest that among HCV-positive patients, increasing exposure to AA poses an increased risk of acquiring PLC.
Direct-acting Antiviral Treatment for Hepatitis C Virus Infection and Risk of Incident Liver Cancer: A Retrospective Cohort StudyAW Singer et al. Aliment Pharmacol Ther 47 (9), 1278-1287. PMID 29516535.In this large, population-based study, DAA-based treatment was associated with a reduced risk of incident liver cancer relative to both no HCV treatment and to interferon …
Economic Evaluation of HCV Testing Approaches in Low and Middle Income CountriesJR Morgan et al. BMC Infect Dis 17 (Suppl 1), 697. PMID 29143681. - ReviewThe evidence base for different HCV testing approaches in LMICs is limited, minimizing the contribution of cost-effectiveness data alone to decision-making and recommenda …
Pharmacological Interventions for Acute Hepatitis C Infection: An Attempted Network Meta-AnalysisM Kalafateli et al. Cochrane Database Syst Rev 3 (3), CD011644. PMID 28285495. - ReviewVery low quality evidence suggests that interferon-alpha may decrease the incidence of chronic HCV infection as measured by sustained virological response. However, the c …