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Studies Illustrate Role of HCV Infection As Risk Factor for Liver Cancer Researchers Stress Importance of Early Detection of HCV:
'HCV now is leading cause of liver cancer in US, liver cancer rates were 2-3 times higher in Mayo Clinic study than currently reported national rates, immigrants are coming into US with higher than expected rates of HCV, screening/treatment guidelines should be considered'
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by George Ochoa, gastroendonews.com
Two Mayo Clinic studies published early this year illustrate the role of chronic hepatitis C virus (HCV) infection in the rising trend of liver cancer.
One study (HCC Rates Very Underestimated by National Data & Driven by HCV in new study by Mayo Clinic - (01/23/12) analyzed longitudinal trends in the incidence, etiology and treatment of hepatocellular carcinoma (HCC), and survival in community residents aged 20 years or older with newly diagnosed HCV infection between Jan. 1, 1976 and Dec. 31, 2008 in Olmsted County, Minn. The researchers found that in earlier periods (1976-1990 and 1991-2000), alcohol use was the most common risk factor associated with HCC, but, in 2001 to 2008, chronic HCV infection filled that role. At the same time, HCC incidence rose dramatically, from 3.5 per 100,000 person-years for the period from 1976 to 1990 to 6.9 per 100,000 person-years between 2001 and 2008. ("our data suggest that the true incidence and burden of HCC in the United States may be even larger than previously thought.....HCC rate in this study is double the national rate")
"The biggest and unique risk factor for HCC is underlying liver disease," said the study's senior author, W. Ray Kim, MD, associate professor of medicine, Mayo Clinic College of Medicine, Rochester, Minn. "Our data showed that previously alcohol, more recently HCV has become the underlying cause."
The second study (Viral Hepatitis Among Somali Immigrants in Minnesota: Association of Hepatitis C With Hepatocellular Carcinoma - "our study showed high rates of anti-HCV positivity in Somalis, confirmed by HCV RNA testing" - (01/23/12) evaluated a cohort of Somali immigrants seen at Mayo Clinic from July 1, 1996 to Oct. 31, 2009. Non-Somali Olmsted County residents served as controls. Investigators calculated the frequencies of chronic hepatitis B virus (HBV) and HCV infection in these populations, and their associations with HCC. Both HBV and HCV occurred frequently in the Somali cohort, but HCV was the major risk factor for HCC. There were significant differences in the HCV genotype distributions between Somalis and non-Somalis.
("If our findings are confirmed, it would be appropriate to recommend that immigrants and refugees from high-risk regions be screened for HCV on entry into the United States and that appropriate therapy for anti-HCV-positive individuals and/or regular surveillance for those at risk for HCC be instituted to reduce the long-term morbidity and mortality due to this virus.")
Hepatitis C Virus Infection and the Rising Incidence (Triples) of Hepatocellular Carcinoma - EDITORIAL - (01/23/12)
In the United States, the incidence of HCC has tripled in the last 3 years. The driving force behind this US epidemic is related to hepatitis C virus (HCV)
The high prevalence of HCV in the Somali sample came as a surprise to the researchers.
"We didn't expect it," said lead author Abdirashid M. Shire, PhD, assistant professor of medicine, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine.
The study, Dr. Shire said, supports the value of early detection of HCV. "It's very important to screen for HCV," he said.
Dr. Kim said that his study also indirectly supports the value of early detection and treatment of HCV infection to improve outcomes.
Drs. Kim and Shire had no relevant financial disclosures.
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