Gamma-GT levels may predict HCC risk in noncirrhotic patients after SVR

WASHINGTON — Heightened levels of serum gamma-glutamyl transferase in noncirrhotic hepatitis C patients who had achieved sustained virologic response signals a significantly greater risk for hepatocellular carcinoma, a speaker said here.

“We think if your patient gets a higher gamma-glutamyl transferase level [gamma-GT] … you have to notice this patient,” Chia-Yen Dai, MD, PhD, of the hepatobiliary division, department of internal medicine at Kaohsiung Medical University Hospital in Taiwan, said at The Liver Meeting.

For the study, researchers analyzed 642 chronic hepatitis patients who achieved SVR after pegylated interferon/ribavirin therapy and followed-up for a mean of 53 months. Eighty-six patients had cirrhosis, and 556 were noncirrhotic.

Of the noncirrhotic patients, 17 (3.1%) developed HCC, and of the cirrhotic patients, 16 (18.6%) developed HCC. Overall, 33 of the 642 patients (5.1%) developed HCC. Among those with cirrhosis, the 1-, 3- and 5-year cumulative incidents rates were 1.2%, 12.2% and 22.6%, respectively, compared with 0.4%, 1.3% and 3.2%, respectively, in noncirrhotic patients (P<.001).

Chia-Yen Dai

By using Cox regression analysis, researchers determined the strongest predictors of HCC occurrence in this population were cirrhosis (P<.001), age (P=.005) and gamma-GT levels (P<.001). In noncirrhotic patients, however, the strongest indicators were gamma-GT levels (HR=6.44) and age (HR=3.68).

Among patients with cirrhosis, heightened gamma-GT levels were not associated with HCC development (P=.53).

“In noncirrhotic patients, the gamma-GT level has the capability of prediction for development of [HCC],” Dai said, noting physicians should not use just cirrhosis to determine follow-up procedures.

Disclosure: See the abstract for a full list of relevant financial disclosures.

For more information:

Dai C-Y. #462: Association of Gamma-Glutamyl Transferase Levels and Hepatocellular Carcinoma Development in Noncirrhotic Patients with Hepatitis C Virus Eradication. Presented at: The Liver Meeting 2013; Nov. 1-5, Washington.