DISEASE PROGRESSION AND HEPATOCELLULAR CARCINOGENESIS IN PATIENTS WITH CHRONIC VIRAL-HEPATITIS - A PROSPECTIVE OBSERVATION OF 2215 PATIENTS

Background/Aims/Methods: The aim of this study was to elucidate the ra te of development to cirrhosis and the rate of appearance of hepatocel lular carcinoma in chronic viral hepatitis and to assess the risk fact ors for the development of disease in 2215 consecutive patients with v iral hepatitis who were prospectively studied for a median observation period of 4.1 years. Results: The rates of development to cirrhosis w ere 7.6%, 21.7%, and 32.2%, at the 5th, 10th, and 15th year, respectiv ely, The carcinogenesis rates were 3.4%, 10.5%, and 22.4% at the 5th, 10th, and 15th year, respectively The appearance rates of cancer in 64 5 patients with only hepatitis B surface antigen and in 1500 patients with only anti-hepatitis C virus antibodies were 2.1% and 4.8% at the 5th year, 4.9% and 13.6% at the 10th year, and 18.8% and 26.0% at the 15th year, respectively, The proportional hazard model identified that the amount of alcohol intake (p=0.0002) and the indocyanine green ret ention rate (p= 0.022) were independently associated with carcinogenes is in hepatitis type B; and stage of hepatitis (p<0.0001), gamma-gluta myl transpeptidase (p=0,0046), history of blood transfusion (p=0.0093) , albumin (p=0.012), and amount of alcohol intake (p=0.031) were indep endently associated with the carcinogenesis rate in hepatitis type C, Although the severity of portal fibrosis was closely correlated with t he future disease development and carcinogenesis in chronic hepatitis C, it was not a good predictor in chronic hepatitis B. Conclusion: The se epidemiological results suggest that there are some differences in the activity and modes of disease progression and cancer promotion bet ween hepatitis B virus infection and hepatitis C virus infection.