Incidence of Hepatocellular Carcinoma in Hepatitis-C Patients Presenting to Lady Reading hospital, Peshawar- A Retrospective Study

Main Article Content

Faisal Saleh Hayat
Zeeshan Ikhtiar
Ilyas Badshah
Muhammad Hussain
Mujtaba Hadi
Rohaid Ikhtiar
Hina Ikhtiar
Muhammad Rizawan
Hamid Ullah
Muhammad Farhan

Abstract

Background: Hepatocellular carcinoma (HCC) is a significant complication of hepatitis C virus (HCV) infection, with varying incidence and outcomes based on treatment history and co-infections like HIV. Understanding the risk factors and progression of HCC in hepatitis C patients is crucial for effective disease management.


Objective: This study aimed to assess the incidence of HCC in patients with a history of hepatitis C, considering factors such as antiviral treatment and HIV co-infection.


Methods: A retrospective study was conducted at Lady Reading Hospital, Peshawar, from March 2022 to July 2023, involving 30 patients with decompensated liver disease or cirrhosis and a history of hepatitis C. Patients were evaluated for demographics, treatment history, PCR status, and HIV co-infection. Data analysis focused on the development of HCC in relation to these variables.


Results: The study included 30 patients with a mean age of 61.57 ± 11.11 years, predominantly male (93.3%). Of these, 73.3% tested PCR positive for HCV, while 26.7% were PCR negative. A total of 43.3% had received antiviral treatment, while 56.7% had not. HIV co-infection was present in 13.3% of patients. HCC was observed in 80% of patients overall. Among those treated and PCR negative, 87.5% developed HCC. In contrast, 76.5% of untreated, PCR-positive patients developed HCC. Among HIV co-infected patients, 75% developed HCC.


Conclusion: The study indicates a high incidence of HCC among hepatitis C patients, regardless of antiviral treatment status or PCR positivity. HIV co-infection appears to be a significant risk factor for HCC development. These findings highlight the need for continuous monitoring and proactive management of hepatitis C patients, especially those co-infected with HIV.

Article Details

How to Cite
Saleh Hayat , F., Ikhtiar, Z., Badshah, I., Hussain, M., Hadi, M., Ikhtiar , R., Ikhtiar, H., Rizawan, M., Ullah , H., & Farhan, M. (2023). Incidence of Hepatocellular Carcinoma in Hepatitis-C Patients Presenting to Lady Reading hospital, Peshawar- A Retrospective Study. Journal of Health and Rehabilitation Research, 3(2), 346–350. https://doi.org/10.61919/jhrr.v3i2.160
Section
Articles

References

Abro IB, Bhatti JM, Siddiqui AA. Hepatocellular Carcinoma in Hepatitis C-Associated Cirrhotic Patients Treated With Different Combinations of Direct-Acting Antiviral Agents Available in Pakistan: A Prospective Observational Study. 2021.

Tahata Y, Sakamori R, Yamada R, Kodama T, Hikita H, Hagiwara H, et al. Prediction model for hepatocellular carcinoma occurrence in patients with hepatitis C in the era of direct‐acting anti‐virals. Alimentary Pharmacology & Therapeutics. 2021;54(10):1340-9.

Shiels MS, Engels EA, Yanik EL, McGlynn KA, Pfeiffer RM, O’Brien TR. Incidence of hepatocellular carcinoma among older Americans attributable to hepatitis C and hepatitis B: 2001 through 2013. Cancer. 2019;125(15):2621-30.

Lee T-Y, Hsu Y-C, Tseng H-C, Lin J-T, Wu M-S, Wu C-Y. Association of daily aspirin therapy with hepatocellular carcinoma risk in patients with chronic hepatitis C virus infection. Clinical Gastroenterology and Hepatology. 2020;18(12):2784-92. e7.

Moosavy SH, Davoodian P, Nazarnezhad MA, Nejatizaheh A, Eftekhar E, Mahboobi H. Epidemiology, transmission, diagnosis, and outcome of Hepatitis C virus infection. Electronic physician. 2017;9(10):5646.

Adhoute X, Penaranda G, Raoul JL, Sellier F, Castellani P, Oules V, et al. Hepatocellular carcinoma recurrence in hepatitis C virus-related cirrhosis treated with direct-acting antivirals: a case–control study. European Journal of Gastroenterology & Hepatology. 2018;30(4):368-75.

Konyn P, Ahmed A, Kim D. Current epidemiology in hepatocellular carcinoma. Expert review of gastroenterology & hepatology. 2021;15(11):1295-307.

Grebely J, Applegate TL, Cunningham P, Feld JJ. Hepatitis C point-of-care diagnostics: in search of a single visit diagnosis. Expert review of molecular diagnostics. 2017;17(12):1109-15.

McGlynn KA, Petrick JL, El‐Serag HB. Epidemiology of hepatocellular carcinoma. Hepatology. 2021;73:4-13.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer. 2015;136(5):E359-E86.

Chen Q, Ayer T, Adee MG, Wang X, Kanwal F, Chhatwal J. Assessment of incidence of and surveillance burden for hepatocellular carcinoma among patients with hepatitis C in the era of direct-acting antiviral agents. JAMA network open. 2020;3(11):e2021173-e.

Axley P, Ahmed Z, Ravi S, Singal AK. Hepatitis C virus and hepatocellular carcinoma: a narrative review. Journal of clinical and translational hepatology. 2018;6(1):79.

Frazzoni L, Sikandar U, Metelli F, Sadalla S, Mazzella G, Bazzoli F, et al. Hepatocellular carcinoma recurrence after hepatitis C virus therapy with direct-acting antivirals. A systematic review and meta-analysis. Journal of clinical medicine. 2021;10(8):1694.

You MW, Kim KW, Shim JJ, Pyo J. Impact of liver‐stiffness measurement on hepatocellular carcinoma development in chronic hepatitis C patients treated with direct‐acting antivirals: a systematic review and time‐to‐event meta‐analysis. Journal of gastroenterology and hepatology. 2021;36(3):601-8.

Bhatti ABH. Hepatocellular carcinoma in Pakistan: an update. Liver Cancer in the Middle East. 2021:387-96.

Zhang Ch, Cheng Y, Zhang S, Fan J, Gao Q. Changing epidemiology of hepatocellular carcinoma in Asia. Liver International. 2022;42(9):2029-41.

El‐Serag HB. Epidemiology of hepatocellular carcinoma. The liver: Biology and pathobiology. 2020:758-72.

Manns MP, Buti M, Gane E, Pawlotsky J-M, Razavi H, Terrault N, et al. Hepatitis C virus infection. Nature reviews Disease primers. 2017;3(1):1-19.

Berretta M, Garlassi E, Cacopardo B, Cappellani A, Guaraldi G, Cocchi S, et al. Hepatocellular carcinoma in HIV‐infected patients: Check early, treat hard. The oncologist. 2011;16(9):1258-69.

Tariq R, Abbas A, Saeed F, Qureshi ZA. Frequency of hepatocellular carcinoma and associated sociodemographic factors in treated patients of chronic hepatitis C. Pakistan Armed Forces Medical Journal. 2021;71(Suppl-1):S52-6.

Yang M, Parikh ND, Liu H, Wu E, Rao H, Feng B, et al. Incidence and risk factors of hepatocellular carcinoma in patients with hepatitis C in China and the United States. Scientific Reports. 2020;10(1):20922.

Haqqi A, Munir R, Khalid M, Khurram M, Zaid M, Ali M, et al. Prevalence of hepatitis C virus genotypes in Pakistan: current scenario and review of literature. Viral immunology. 2019;32(9):402-13.

Ullah A, Rehman IU, Ahmad J, Gohar M, Ahmad S, Ahmad B. Hepatitis-C virus and cirrhosis: an overview from Khyber Pakhtunkhwa province of Pakistan. Viral Immunology. 2020;33(5):396-403.

Muzica CM, Stanciu C, Huiban L, Singeap A-M, Sfarti C, Zenovia S, et al. Hepatocellular carcinoma after direct-acting antiviral hepatitis C virus therapy: A debate near the end. World journal of gastroenterology. 2020;26(43):6770.