Ameer Abutaleb1, Jose Antonio Almario2, Saleh Alghsoon2, Ji Ae Yoon3, Kate Gheysens2, Shyam Kottilil4, Eleanor Wilson4. 1. Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, USA. 2. Department of Medicine, University of Maryland Medical Center, USA. 3. University of Maryland School of Medicine, USA. 4. Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, USA.
Abstract
BACKGROUND AND AIMS: An estimated 2.4 million Americans, including more than 150,000 veterans, are chronically infected with hepatitis C virus (HCV). HCV is estimated to cause roughly 25% of all hepatocellular carcinoma. Although its mechanism is unknown, developing evidence suggests that chronic HCV infection is also associated with the development of extrahepatic cancers (EHCs). This paper aims to assess the relationship of hepatic fibrosis and chronic HCV with the risk of developing EHC. METHODS: We conducted a single-center retrospective chart review of 1541 patients linked to the hepatitis clinic at the Veterans Affairs (VA) Maryland Health Care System who underwent transient elastography for evaluation and management of liver disease from 2014 to 2018. Liver fibrosis was measured using ultrasound and transient elastography. Extrahepatic cancer and site was identified by a retrospective chart review. RESULTS: In adjusted analysis of EHCs, advanced age (OR: 1.97, 95% CI: 1.30-3.04), and higher measured stiffness (OR 2.19, 95% CI: 1.32-3.64) were associated with an increased likelihood of developing EHC, controlling for HBV infection, HCV exposure, heavy alcohol use, and body mass index. CONCLUSIONS: We observed a significant association between increasing age and increasing levels of liver fibrosis with increased risk of EHC, notably prostate, head and neck squamous cell, lung, and hematologic cancers.
BACKGROUND AND AIMS: An estimated 2.4 million Americans, including more than 150,000 veterans, are chronically infected with hepatitis C virus (HCV). HCV is estimated to cause roughly 25% of all hepatocellular carcinoma. Although its mechanism is unknown, developing evidence suggests that chronic HCV infection is also associated with the development of extrahepatic cancers (EHCs). This paper aims to assess the relationship of hepatic fibrosis and chronic HCV with the risk of developing EHC. METHODS: We conducted a single-center retrospective chart review of 1541 patients linked to the hepatitis clinic at the Veterans Affairs (VA) Maryland Health Care System who underwent transient elastography for evaluation and management of liver disease from 2014 to 2018. Liver fibrosis was measured using ultrasound and transient elastography. Extrahepatic cancer and site was identified by a retrospective chart review. RESULTS: In adjusted analysis of EHCs, advanced age (OR: 1.97, 95% CI: 1.30-3.04), and higher measured stiffness (OR 2.19, 95% CI: 1.32-3.64) were associated with an increased likelihood of developing EHC, controlling for HBV infection, HCV exposure, heavy alcohol use, and body mass index. CONCLUSIONS: We observed a significant association between increasing age and increasing levels of liver fibrosis with increased risk of EHC, notably prostate, head and neck squamous cell, lung, and hematologic cancers.
Authors: Roberta D'Ambrosio; Alessio Aghemo; Maria Grazia Rumi; Elisabetta Degasperi; Angelo Sangiovanni; Marco Maggioni; Mirella Fraquelli; Riccardo Perbellini; William Rosenberg; Pierre Bedossa; Massimo Colombo; Pietro Lampertico Journal: Liver Int Date: 2018-03-12 Impact factor: 5.828