| Title: |
Features of patients who developed hepatocellular carcinoma after direct-acting antiviral treatment for hepatitis C Virus. |
| Authors: |
Mawatari, Seiichi, Kumagai, Kotaro, Oda, Kohei, Tabu, Kazuaki, Ijuin, Sho, Fujisaki, Kunio, Tashima, Shuzo, Inada, Yukiko, Uto, Hirofumi, Saisyoji, Akiko, Hiramine, Yasunari, Hashiguchi, Masafumi, Tamai, Tsutomu, Hori, Takeshi, Taniyama, Ohki, Toyodome, Ai, Sakae, Haruka, Kure, Takeshi, Sakurai, Kazuhiro, Moriuchi, Akihiro |
| Source: |
PLoS ONE; 1/12/2022, Vol. 17 Issue 1, p1-21, 21p |
| Subject Terms: |
HEPATITIS C virus, HEPATITIS C, HEPATOCELLULAR carcinoma, HYALURONIC acid |
| Abstract: |
Background: The features of hepatitis C virus patients with a sustained virologic response (SVR) who developed hepatocellular carcinoma (HCC) after direct-acting antiviral (DAA) therapy are unclear. Methods: The study population included 1494 DAA-SVR patients without a history of HCC. The cumulative carcinogenesis rate after the end of treatment (EOT) and factors related to HCC were analyzed. Results: Sixty (4.0%) patients developed HCC during a median observation period of 47.6 months. At four years, the cumulative carcinogenesis rate was 4.7%. A Cox proportional hazards analysis showed that age ≥73 years (hazard ratio [HR]: 2.148), male sex (HR: 3.060), hyaluronic acid (HA) ≥75 ng/mL (HR: 3.996), alpha-fetoprotein at EOT (EOT-AFP) ≥5.3 ng/mL (HR: 4.773), and albumin at EOT (EOT-Alb) <3.9 g/dL (HR: 2.305) were associated with HCC development. Especially, EOT-AFP ≥5.3 ng/mL was associated with HCC development after 3 years from EOT (HR: 6.237). Among patients who developed HCC, AFP did not increase in patients with EOT-AFP <5.3 ng/mL at the onset of HCC. Of these 5 factors, EOT-AFP ≥5.3 ng/mL was scored as 2 points; the others were scored as 1 point. The 4-year cumulative carcinogenesis rate for patients with total scores of 0–2, 3–4, and 5–6 points were 0.6%, 11.9%, and 27.1%, respectively (p<0.001). Conclusions: EOT-AFP ≥5.3 ng/mL is useful for predicting HCC development after an SVR. However, AFP does not increase in patients with EOT-AFP <5.3 ng/mL at the onset of HCC. The combination of EOT-AFP, age, sex, HA, and EOT-Alb is important for predicting carcinogenesis. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
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