A Novel Standard for Hepatocellular Carcinoma Screening Intensity After Hepatitis C Elimination
Akio Miyasaka,1,2 Yuichi Yoshida,1,2 Akiko Suzuki,1 Kei Sawara,1,3 Yasuhiro Takikawa1 1Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Shiwa-gun, Iwate, Japan; 2Department of Gastroenterology, Iwate Prefectural Ninohe Hospital, Ninohe, Iwate, Jap...
Guardado en:
| Autores principales: | , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Dove Medical Press
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/faef1734927145a3979fb6afe189eef9 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| Sumario: | Akio Miyasaka,1,2 Yuichi Yoshida,1,2 Akiko Suzuki,1 Kei Sawara,1,3 Yasuhiro Takikawa1 1Division of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Shiwa-gun, Iwate, Japan; 2Department of Gastroenterology, Iwate Prefectural Ninohe Hospital, Ninohe, Iwate, Japan; 3Department of Gastroenterology, Iwate Prefectural Kamaishi Hospital, Kamaishi, Iwate, JapanCorrespondence: Akio MiyasakaDivision of Hepatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3695, JapanTel +81-19-613-7111Fax +81-19-907-7166Email akimiya@iwate-med.ac.jpPurpose: To investigate long-term incidence of hepatocellular carcinoma (HCC) and the factors associated with HCC occurrence after achieving sustained virological response (SVR) by direct-acting antiviral agent (DAA) treatment for hepatitis C virus (HCV).Methods: A total of 476 patients (male 227, female 249; median age 68) with chronic HCV infection who were treated with DAAs and achieved SVR were analyzed. The incidence of HCC and factors related to the development of HCC after HCV elimination were evaluated.Results: The median observation period was 46.4 months. During this period, 40 patients developed HCC. The incidence rates of HCC were 3.7%, 6.0%, 7.1%, 9.3%, and 10.6% at 1, 2, 3, 4, and 5 years post-SVR12, respectively. Multivariate analysis with pre-treatment factors revealed that platelet count, α-fetoprotein, fibrosis-4 (Fib-4) index, and previous HCC history were independent factors that contributed to development of HCC post-SVR following DAA treatment. Of these factors, previous HCC history was the most significant, followed by Fib-4 index. Using these two factors, a novel scoring system was established. The presence of previous HCC history was scored as 2, and then, the absence of previous HCC history was stratified by Fib-4 index (≥ 3.07, 1; < 3.07, 0). The HCC occurrence rate at 5 years was 0.4% in the 0-point group, 6.8% in the 1-point group, and 55.6% in the 2-point group, respectively.Conclusion: Fib-4 index and previous HCC history were independent predictors for development of HCC after DAA treatment. Patients with these risk factors require careful observation.Keywords: hepatocellular carcinoma, antiviral agents, sustained virological response |
|---|