Lifestyles associated with prognosis after eradication of hepatitis C virus: a prospective cohort study in Japan

Abstract Background Hepatocellular carcinoma develops in some patients with hepatitis C virus (HCV), even after achieving sustained virological response (SVR). This prospective cohort study of SVR patients examined factors associated with liver disease progression. Methods Participants were patients who had visited a hospital for clinical follow-up of chronic HCV infection in 2005 and had reached SVR as a result of subsequent antiviral treatment. Baseline information including lifestyle and dietary habits before SVR were collected in 2005 using self-administered questionnaires, and clinical information before SVR was collected from medical records in 2005. Study outcome was liver disease progression such as liver cirrhosis, hepatocellular carcinoma, and/or liver disease-related death after SVR. Logistic regression models were employed to calculate odds ratios (ORs) and 95% confidence intervals for each variable. Results Of 180 SVR patients, 27 patients (15%) showed liver disease progression after SVR: 26 (14%) were diagnosed with liver cirrhosis, two (1%) with hepatocellular carcinoma, and/or one (0.6%) with liver-disease related death. Besides older age at SVR (OR=6.65, P=0.01) and aspartate aminotransferase-to-platelet ratio index score ≥ 1.0 before SVR (OR=5.22, P<0.01), alcohol drinkers before SVR (OR=2.83, P=0.09) appeared to be associated with liver disease progression after SVR, whereas higher consumption of vitamin B12 before SVR showed a decreased OR for liver disease progression (OR=0.35, P=0.09). Conclusions Alcohol drinking was associated with liver disease progression, whereas vitamin B12 intake had protective effects for liver disease progression after eradication of HCV. Further studies are needed to confirm these findings.