Predictors of Developing Hepatocellular Carcinoma in Treated HCV-Carriers in Morocco according to University Hospital Experience

Introduction. Hepatitis C is the first major cause for HCC in Morocco. Antiviral treatment reduces the risk of developing HCC but few cases of HCC in HCV-treated patients were reported. We aimed to define this population’s features and to identify predictive factors of developing HCC. Patients and Methods. We included all HCV carriers who developed HCC after antiviral treatment from January 2002 to April 2010. We compare HCV-treated patients with no developed HCC to HCC population using khi-2 and Fisher Exact analysis. Results. 369 HVC-treated patients were considered, and 20 HCC were reported. The risk of HCC was not significant according to gender and genotypes (resp., and ). Advanced age and severe fibrosis were significant risk factors (resp., and ). HCC was reported in 2.6% of sustained virological responders versus 12.5% of nonresponders ( ). Conclusion. In our series, 5% of previously treated patients developed an HCC. Advanced age and severe fibrosis at HCV diagnosis are predictive factors of HCC occurrence. Sustained virological response reduces considerably the risk of HCC occurrence but screening is indicated even after SVR. 1. Introduction Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world. It is the main type of primary liver cancers and the third most common cause of cancer mortality worldwide [1]. The epidemiology of HCC is variable according to the geographic area because of differences in the repartition of major causative factors. In countries where hepatitis C virus infection is endemic such as Japan and Egypt, high prevalence of HCV infection is reported among people with HCC. In Morocco, according to our department register and the results of a regional study [2], the major risk factor for hepatocellular carcinoma is chronic hepatitis especially hepatitis C virus infection. Hepatocellular carcinoma is closely associated to liver cirrhosis, which is a true precancerous state. Hepatitis viruses B and C contribute to this condition if not treated or diagnosed late [3]. Hepatocarcinogenesis is a long and heterogeneous process and there is still much to understand. The combination of pegylated interferon to ribavirin given for 24 or 48 weeks—according to genotype—has been retained for long years ago as the only consensual and standard treatment of chronic hepatitis C before the development of antiproteasis and antipolymerases for selected patients. It is established too that antiviral treatment limits fibrosis progression and reduces risk of developing HCC but few cases of？？HCC in HCV carriers are