Risk Factors Associated With Development of Hepatocellular Carcinoma in Hepatitis C Virus Patients

Hepatitis C virus (HCV) is the main etiology of advanced liver fibrosis and cirrhosis with significant risk of progression to hepatocellular carcinoma (HCC). Several epidemiologic studies have documented a lot of risk factors related to the progression of HCC in chronic HCV patients. Factors that increase the risk of HCC development include obesity, diabetes mellitus, nonalcoholic fatty liver disease, aflatoxin exposure, alcohol consumption, occult hepatitis C infection, and genetic variations. HCV patients with genotypes 3 and 1 are also more liable to develop HCC. Also, male gender and higher age are considered as independent risk factors for HCC. Using the newly discovered direct-acting antivirals (DAAs), great improvement in sustained virological immune response (SVR) has occurred >90% in treated patients irrespective of their fibrosis level. Nevertheless, the progression to HCC in HCV patients who achieve SVR stays vulnerable to HCC development, especially patients with advanced fibrosis and/or cirrhosis.