Hepatocellular carcinoma risk assessment by the measurement of liver stiffness variations in HCV cirrhotics treated with direct acting antivirals

2018 ◽  
Vol 50 (6) ◽  
pp. 573-579 ◽  
Author(s):  
Federico Ravaioli ◽  
Fabio Conti ◽  
Stefano Brillanti ◽  
Pietro Andreone ◽  
Giuseppe Mazzella ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Assessment ◽  
Liver Stiffness ◽  
Direct Acting Antivirals ◽  
Direct Acting ◽  
Carcinoma Risk

scholarly journals Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3414
Author(s):  
Hye Won Lee ◽  
Dai Hoon Han ◽  
Hye Jung Shin ◽  
Jae Seung Lee ◽  
Seung Up Kim ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Pegylated Interferon ◽  
Direct Acting Antivirals ◽  
Treatment Regimens ◽  
Direct Acting ◽  
Similar Risk ◽  
Carcinoma Risk

By pegylated interferon (PegIFN)-free direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection, a sustained virological response (SVR) rate >95% can be attained with a satisfactory tolerability and shorter treatment duration. However, it remains controversial whether there is any difference in prognosis depending on regimens—PegIFN or DAAs. We compared the probabilities of hepatocellular carcinoma (HCC) development between patients achieving an SVR by PegIFN/ribavirin (PegIFN group, n = 603) and DAAs (DAAs group, n = 479). The DAAs group was significantly older and had a higher proportion of cirrhosis than the PegIFN group. Before adjustment, the DAAs group had a higher HCC incidence than the PegIFN group (p < 0.001). However, by multivariate analyses, the DAAs (vs. PegIFN) group was not associated with HCC risk (adjusted hazard ratio 0.968, 95% confidence interval 0.380–2.468; p = 0.946). Old age, male, higher body mass index, cirrhosis, and lower platelet count were associated with increased HCC risk (all p < 0.05). After propensity score matching (PSM), a similar HCC risk between the two groups was observed (p = 0.372). We also compared HCC incidences according to sofosbuvir (SOF)-based and SOF-free DAAs, showing a similar risk in both groups before adjustment (p = 0.478) and after PSM (p = 0.855). In conclusion, post-SVR HCC risks were comparable according to treatment regimens; PegIFN- vs. DAA-based regimens and SOF-based vs. SOF-free DAA regimens. Further studies with a longer follow-up period are required.

scholarly journals Risk of Hepatocellular Carcinoma after HCV Clearance by Direct-Acting Antivirals Treatment Predictive Factors and Role of Epigenetics

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1351 ◽  
Author(s):  
Luca Rinaldi ◽  
Riccardo Nevola ◽  
Gianluigi Franci ◽  
Alessandro Perrella ◽  
Giusy Corvino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Immune Surveillance ◽  
Liver Stiffness ◽  
Virologic Response ◽  
Direct Acting Antivirals ◽  
Direct Role ◽  
Direct Acting ◽  
The Impact

Direct-acting antivirals (DAAs) induce a rapid virologic response (SVR) in up to 99% of chronic hepatitis C patients. The role of SVR by DAAs on the incidence or recurrence of hepatocellular carcinoma (HCC) is still a matter of debate, although it is known that SVR does not eliminate the risk of HCC. In this review, we made an updated analysis of the literature data on the impact of SVR by DAAs on the risk of HCC as well as an assessment of risk factors and the role of epigenetics. Data showed that SVR has no impact on the occurrence of HCC in the short–medium term but reduces the risk of HCC in the medium–long term. A direct role of DAAs in the development of HCC has not been demonstrated, while the hypothesis of a reduction in immune surveillance in response to the rapid clearance of HCV and changes in the cytokine pattern influencing early carcinogenesis remains to be further elucidated. HCV induces epigenetic alterations such as modifications of the histone tail and DNA methylation, which are risk factors for HCC, and such changes are maintained after HCV clearance. Future epigenetic studies could lead to identify useful biomarkers and therapeutic targets. Cirrhosis has been identified as a risk factor for HCC, particularly if associated with high liver stiffness and α-fetoprotein values, diabetes and the male sex. Currently, considering the high number and health cost to follow subjects’ post-HCV clearance by DAAs, it is mandatory to identify those at high risk of HCC to optimize management.

Hepatocellular carcinoma risk in hepatitis C stage‐3 fibrosis after sustained virological response with direct‐acting antivirals

2021 ◽  
Author(s):  
María Sánchez‐Azofra ◽  
Inmaculada Fernández ◽  
María L. García‐Buey ◽  
Lourdes Domínguez‐Domínguez ◽  
Conrado M. Fernández‐Rodríguez ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Virological Response ◽  
Direct Acting Antivirals ◽  
Direct Acting ◽  
Carcinoma Risk

scholarly journals Liver stiffness measurement predicts hepatocellular carcinoma development in patients treated with direct-acting antivirals

JGH Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Yoshihiko Tachi ◽  
Takanori Hirai ◽  
Yuko Kojima ◽  
Yoji Ishizu ◽  
Takashi Honda ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Stiffness ◽  
Direct Acting Antivirals ◽  
Liver Stiffness Measurement ◽  
Stiffness Measurement ◽  
Direct Acting
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