Decreased alpha-fetoprotein levels in HCV cirrhotic patients after direct-acting antiviral agents therapy. Does this indicate a reduced risk of hepatocellular carcinoma?

2017 ◽  
Vol 49 (1) ◽  
pp. e56
Author(s):  
F. De Leonardis ◽  
C. Masetti ◽  
P. Rossi ◽  
D. Di Paolo ◽  
A. Bosa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Antiviral Agents ◽  
Alpha Fetoprotein ◽  
Direct Acting Antiviral ◽  
Cirrhotic Patients ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents ◽  
Reduced Risk

scholarly journals Hepatocellular Carcinoma in Hepatitis C-Associated Cirrhotic Patients Treated With Different Combinations of Direct-Acting Antiviral Agents Available in Pakistan: A Prospective Observational Study

2021 ◽  
Author(s):  
Irshad Batool Abro ◽  
Jamil Muqtadir Bhatti ◽  
Ali Akbar Siddiqui
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prospective Observational Study ◽  
Antiviral Agents ◽  
Abdominal Ultrasound ◽  
Meld Score ◽  
Alpha Fetoprotein ◽  
Direct Acting Antiviral ◽  
Pugh Class ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

Abstract BackgroundHepatitis C virus (HCV) is a significant cause of chronic liver disease, which can result in cirrhosis and hepatocellular carcinoma (HCC). Direct-acting antiviral agents (DAAs) are associated with a significant rise in sustained virologic response and reduced treatment duration. We performed this study to assess the incidence of HCC in patients with HCV-associated cirrhosis following therapy with DAAs available in Pakistan.MethodsWe conducted a prospective observational study at Isra University Hospital Hyderabad from July 2019 to August 2020. Three hundred fourteen patients met the inclusion criteria and were included. We recorded baseline demographic characteristics, Child-Pugh class, model for end-stage liver disease (MELD) score, alpha-fetoprotein level, and abdominal ultrasound/computed tomography (CT) scan before and after treatment. We also noted the duration of DAA treatment and the types of DAA used. HCC was considered present according to characteristic imaging findings on abdominal ultrasound/CT scans. ResultsA total of 314 patients were enrolled in the study. The mean age of patients who developed HCC was 46.7 years ± 10.3 years. Of the patients who developed HCC, 20 (69%) were male, and nine (31%) were female (p=0.221). Five patients who developed HCC also had diabetes (17.2%; p=0.174) and 17 (58.6%) were smokers (p=0.001). Among patients treated with a combination of sofosbuvir/daclatasvir, 20 (69%) developed HCC. Nine patients (31%) treated with a combination of sofosbuvir/velpatasvir developed HCC (p=0.1). Eight patients younger than 40 years (27.6%) developed HCC, and 21 patients aged 40 years or older (72.6%) developed HCC (p=0.55). HCC was common in Child-Pugh class A patients (n=19; 65.6%). Twenty-three patients (79.3%) with a MELD score <9 developed HCC. Eight percent of patients treated with sofosbuvir/daclatasvir for 12 weeks developed HCC, and 15% developed HCC after 24 weeks of treatment with sofosbuvir/daclatasvir. When treated with sofosbuvir/velpatasvir for 12 and 24 weeks, 4% and 9% developed HCC, respectively. Alpha-fetoprotein was elevated in all patients diagnosed with HCC, while only 14.7% of those with no HCC had elevated alpha-fetoprotein levels. ConclusionDAAs were associated with an increased risk of HCC. HCC was more commonly seen in patients treated with a combination of sofosbuvir/daclatasvir than sofosbuvir/daclatasvir.

scholarly journals Direct-acting antiviral agents and risk of Hepatocellular carcinoma: critical appraisal of the evidence

2021 ◽  
pp. 100568
Author(s):  
Ciro Celsa ◽  
Caterina Stornello ◽  
Paolo Giuffrida ◽  
Carmelo Marco Giacchetto ◽  
Mauro Grova ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Critical Appraisal ◽  
Antiviral Agents ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

scholarly journals Predictive Factors for Hepatocellular Carcinoma Occurrence or Recurrence after Direct-Acting Antiviral Agents in Patients with Chronic Hepatitis C

2019 ◽  
Vol 28 (1) ◽  
pp. 63-71 ◽  
Author(s):  
Yu Yoshimasu ◽  
Yoshihiro Furuichi ◽  
Yoshitaka Kasai ◽  
Hirohito Takeuchi ◽  
Katsutoshi Sugimoto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Platelet Count ◽  
Recurrence Rate ◽  
Cumulative Incidence ◽  
Antiviral Agents ◽  
Occurrence Rate ◽  
Factors Associated ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Direct Acting Antiviral Agents

Background & Aims: Direct-acting antiviral agents (DAAs) and the risk of hepatocellular carcinoma (HCC) is controversially reported in the literature. The primary endpoints of this study were to clarify the cumulative incidence and recurrence rate of HCC after DAA treatment. The secondary endpoints were to identify the factors associated with the occurrence or recurrence of HCC after DAAs treatment.Methods: Of 234 HCV patients, 211 with no history of HCC (no-HCC-history group) and 23 with previous treated HCC history (HCC-history group) were treated with DAAs and followed for more than 24 weeks to determine the incidence of HCC. Platelet count, albumin, α-fetoprotein (AFP) level, L3%, the FIB-4 index and APRI scores were analyzed as possible factors associated with HCC occurrence and recurrence. An intergroup comparison was made of the cumulative incidence of HCC. Cox proportional hazards regression was used to determine associations between blood test values and risk of HCC.Results: The median observation period was 21 months. Cumulative incidence of HCC was higher in the HCChistory group than in the no-HCC-history group (p < 0.0001, 19.0 and 0.52 per 100 patient-years, respectively). Univariate analysis revealed platelet count, albumin, α-fetoprotein (AFP) level, AFP-L3%, and FIB-4 index and APRI scores at the end of DAA treatment as being significantly associated with occurrence/recurrence of HCC. Multivariate analysis revealed that AFP levels before and after the administration of DAAs and AFP-L3% after DAA were independently associated with the occurrence/recurrence of HCC (p = 0.045, 0.043, 0.005, respectively).Conclusion: The HCC occurrence rate after DAA treatment was very low, and the recurrence rate lower than that in previous interferon reports. The AFP level and AFP-L3% were identified as important factors in predicting occurrence/recurrence of HCC. Careful observation is needed when increased levels of AFP or AFP-L3% after DAAs treatment are observed.

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