Extrahepatic Malignancy Among Patients With Chronic Hepatitis C After Antiviral Therapy: A Real-World Nationwide Study on Taiwanese Chronic Hepatitis C Cohort (T-COACH)

Chung Feng Huang, Hsueh Chou Lai, Chi Yi Chen, Kuo Chih Tseng, Hsing Tao Kuo, Chao Hung Hung, Jing Houng Wang, Jyh Jou Chen, Pei Lun Lee, Rong Nan Chien, Chi Chieh Yang, Gin Ho Lo, Chi Ming Tai, Chih Wen Lin, Jia Horng Kao, Chun Jen Liu, Chen Hua Liu, Sheng Lei Yan, Ming Jong Bair, Chun Yen LinWei Wen Su, Cheng Hsin Chu, Chih Jen Chen, Shui Yi Tung, Ching Chu Lo, Pin Nan Cheng, Yen Cheng Chiu, Chia Chi Wang, Jin Shiung Cheng, Wei Lun Tsai, Han Chieh Lin, Yi Hsiang Huang, Ming Lun Yeh, Jee Fu Huang, Chia Yen Dai, Wan Long Chuang, Pei Chien Tsai, Cheng Yuan Peng, Ming Lung Yu

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INTRODUCTION: Chronic hepatitis C virus (HCV) infection is associated with nonhepatocellular carcinoma malignancies. We aimed to evaluate whether achieving a sustained virological response (SVR, defined as HCV RNA seronegativity throughout posttreatment 24-week follow-up) could reduce the risk of non-hepatocellular carcinoma malignancy in a real-world nationwide Taiwanese Chronic Hepatitis C Cohort (T-COACH). METHODS: A total of 10,714 patients with chronic hepatitis C who had received interferon-based therapy (8,186 SVR and 2,528 non-SVR) enrolled in T-COACH and were linked to the National Cancer Registry database for the development of 12 extrahepatic malignancies, including those with potential associations with HCV and with the top-ranking incidence in Taiwan, over a median follow-up period was 3.79 years (range, 0-16.44 years). RESULTS: During the 44,354 person-years of follow-up, 324 (3.02%) patients developed extrahepatic malignancies, without a difference between patients with and without SVR (annual incidence: 0.69% vs 0.87%, respectively). Compared with patients with SVR, patients without SVR had a significantly higher risk of gastric cancer (0.10% vs 0.03% per person-year, P = 0.004) and non-Hodgkin lymphoma (NHL) (0.08% vs 0.03% per person-year, respectively, P = 0.03). When considering death as a competing risk, non-SVR was independently associated with gastric cancer (hazard ratio [HR]/95% confidence intervals [CIs]: 3.29/1.37-7.93, P = 0.008). When patients were stratified by age, the effect of SVR in reducing gastric cancer (HR/CI: 0.30/0.11-0.83) and NHL (HR/CI: 0.28/0.09-0.85) was noted only in patients aged <65 years but not those aged >65 years. DISCUSSION: HCV eradication reduced the risk of gastric cancer and NHL, in particular among younger patients, indicating that patients with chronic hepatitis C should be treated as early as possible.

Original languageEnglish
Pages (from-to)1226-1235
Number of pages10
JournalThe American journal of gastroenterology
Issue number8
Publication statusPublished - 2020 Aug 1

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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