BackgroundThere are very few studies on the incidence and risk factors of hepatitis C virus (HCV)-induced hepatocellular carcinoma (HCC) in the absence of advanced fibrosis. Our objective was to identify the clinical–pathological features of these patients. MethodsWe retrospectively reviewed 162 patients admitted to our hospital for HCV-related HCC between 2000 and 2010. Patients with hepatitis of other aetiologies, human immunodeficiency virus co-infection, or treated with interferon were excluded. We compared demographic, laboratory, clinical and outcome parameters of patients with and without advanced fibrosis. Results137 patients had advanced fibrosis (85%). Median age was higher in the advanced fibrosis vs. the non-advanced fibrosis group (62 vs. 65 years, respectively; p=0.025). Steatosis was significantly more frequent in patients with advanced fibrosis compared to those without advanced fibrosis (43% vs. 20%, respectively; p=0.032). Independent predictors associated to the occurrence of HCC in patients without advanced fibrosis were hepatitis B core antigen (odds ratio: 3.86; p=0.044) and duration of hepatitis C infection (odds ratio: 1.21; p=0.003). ConclusionsRisk factors such as steatosis or diabetes were not frequent in patients without advanced fibrosis. Further studies are needed to evaluate the role of occult hepatitis B and the duration of hepatitis infection in patients with HCC and chronic hepatitis C without advanced fibrosis.