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Abbas et al. Hepatoma Res 2018;4:43 Hepatoma Research
DOI: 10.20517/2394-5079.2018.26

Review Open Access

Factors predicting hepatocellular carcinoma in
hepatitis C infection

Zaigham Abbas , Minaam Abbas 2
1
1 Department of Hepatogastroenterology, Dr. Ziauddin University Hospital, Clifton, Karachi 75500, Pakistan.
2 Wellcome/Cancer Research UK Gurdon Institute, University of Cambridge, Tennis Court Road, Cambridge CB2 1QN, UK.
Correspondence to: Dr. Zaigham Abbas, Department of Hepatogastroenterology, Dr. Ziauddin University Hospital, Clifton,
Karachi 75500, Pakistan. E-mail: drzabbas@gmail.com

How to cite this article: Abbas Z, Abbas M. Factors predicting hepatocellular carcinoma in hepatitis C infection. Hepatoma Res
2018;4:43. http://dx.doi.org/10.20517/2394-5079.2018.26

Received: 20 Mar 2018 First Decision: 12 Jun 2018 Revised: 19 Jun 2018 Accepted: 20 Jun 2018 Published: 8 Aug 2018

Science Editor: Guang-Wen Cao Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
Hepatitis C virus (HCV) has emerged as a leading cause of hepatocellular carcinoma (HCC). In most cases, the virus
causes HCC in the presence of chronic hepatic inflammation, advanced fibrosis, and cirrhosis. A combination of viral,
environmental, and genetic factors are likely to determine the host immune response to the infection as well as the
progression to HCC. Clinical and epidemiologic studies have identified many of the risk factors associated with HCC
development in patients with chronic hepatitis C. Male sex and older age are considered as independent risk factors
for HCC, while alcohol consumption accelerates fibrosis, increasing the risk for progression to HCC. Obesity, diabetes
mellitus, nonalcoholic fatty liver disease, aflatoxin exposure and occult hepatitis B infection, all contribute to a higher
HCC risk. HCV patients infected with HCV genotype 3 are also more likely to develop HCC and genetic variations such
as single nucleotide polymorphisms, which may also alter the risk. Sustained virological response to the antiviral therapy
results in significantly more favorable long-term outcomes. The incidence of HCC after HCV eradication is similar
between patients treated with peginterferon plus ribavirin and direct-acting antiviral therapy.

Keywords: Hepatitis C, hepatocellular carcinoma, risk factors, alcohol, cirrhosis, diabetes, nonalcoholic fatty liver disease,
directly acting antiviral agents

INTRODUCTION
Hepatocellular carcinoma (HCC) is the fifth most common cause of cancer in men and ranks seventh among
women. It is also the third leading cause of cancer-related deaths in the world . Hepatitis C virus (HCV)
[1,2]
has emerged as the foremost cause of HCC in many countries and has surpassed hepatitis B virus (HBV)

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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