Characteristics of Patients and Factors Associated With the Development of Hepatitis C Virus-Associated Hepatocellular Carcinoma in an Urban, Primary-Care Based Hepatitis C Clinic

Abstract

Chronic hepatitis C virus infection (HCV) is one of the leading causes of hepatocellular carcinoma (HCC) in the United States. Using a retrospective cross-sectional analysis, this study identified patient characteristics and factors associated with the development of HCV-associated HCC in 113 patients seen in the primary care-based HCV clinic in Grady Memorial Hospital, a public, safety-net healthcare facility in Atlanta, Georgia from October 2013 to November 2024. The study population was comprised of mostly African American men with high rates of polysubstance use, 96.5% of whom had cirrhosis. Patients treated for HCV prior to HCC diagnosis were older at HCC diagnosis (mean difference 3.248, p-value 0.037), had a longer latency period between HCV and HCC diagnoses (mean difference 38.740, p-value 0.002), had prior HCC screening (mean difference 0.547, p-value 0.000), and less time from last HCC screening to HCC diagnosis (mean difference −25.332, p-value 0.012), and had a lower Child-Pugh Score at time of HCC diagnosis (mean difference −0.300, p-value 0.036) compared to patients who were not treated for HCV. For patients who achieved SVR prior to HCC, HCV genotype 1 was associated with longer time to HCC diagnosis (p-value 0.030), and a higher FIB-4 index at the time of achieving SVR and longer knowledge of HCV infection were associated with shorter time to developing HCC (p-value 0.003; p-value 0.044). Ultimately, this study highlights the importance of understanding risk factors for HCV-associated HCC in underserved populations which could help providers tailor their approach to mitigate the risk of HCC.