The aim of this study was to elucidate the rate of development to cirrhosis and the
rate of appearance of hepatocellular carcinoma in chronic viral hepatitis and to assess
the risk factors for the development of disease in 2215 consecutive patients with
viral hepatitis who were prospectively studied for a median observation period of
4.1 years.
The rates of development to cirrhosis were 7.6%, 21.7%, and 32.2%, at the 5th, 10th,
and 15th year, respectively. The carcinogenesis rates were 3.4%, 10.5%, and 22.4%
at the 5th, 10th, and 15th year, respectively. The appearance rates of cancer in 645
patients with only hepatitis B surface antigen and in 1500 patients with only anti-hepatitis
C virus antibodies were 2.1% and 4.8% at the 5th year, 4.9% and 13.6% at the 10th
year, and 18.8% and 26.0% at the 15th year, respectively. The proportional hazard
model identified that the amount of alcohol intake (p= 0.0002) and the indocyanine
green retention rate (p= 0.022) were independently associated with carcinogenesis
in hepatitis type B; and stage of hepatitis (p<0.0001), gamma-glutamyl transpeptidase
(p= 0.0046), history of blood transfusion (p=0.0093), albumin (p=0.012), and amount
of alcohol intake (p= 0.031) were independently associated with the carcinogenesis
rate in hepatitis type C. Although the severity of portal fibrosis was closely correlated
with the future disease development and carcinogenesis in chronic hepatitis C, it
was not a good predictor in chronic hepatitis B.
These epidemiological results suggest that there are some differences in the activity
and modes of disease progression and cancer promotion between hepatitis B virus infection
and hepatitis C virus infection.