Postoperative direct‐acting antiviral treatment after liver resection in patients with hepatitis C virus‐related hepatocellular carcinoma

2021 ◽  
Author(s):  
Shogo Tanaka ◽  
Hiroji Shinkawa ◽  
Akihiro Tamori ◽  
Shigekazu Takemura ◽  
Sawako Uchida‐Kobayashi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Liver Resection ◽  
Antiviral Treatment ◽  
Direct Acting Antiviral ◽  
Direct Acting

scholarly journals Features of patients who developed hepatocellular carcinoma after direct-acting antiviral treatment for hepatitis C Virus

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262267
Author(s):  
Seiichi Mawatari ◽  
Kotaro Kumagai ◽  
Kohei Oda ◽  
Kazuaki Tabu ◽  
Sho Ijuin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Proportional Hazards ◽  
Antiviral Treatment ◽  
Virologic Response ◽  
Cox Proportional Hazards ◽  
Direct Acting Antiviral ◽  
History Of ◽  
Direct Acting

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.

scholarly journals Predictive Factors for Hepatocellular Carcinoma Development after Direct-Acting Antiviral Treatment of HCV

Livers ◽  
2021 ◽  
Vol 1 (4) ◽  
pp. 313-321
Author(s):  
Zuzana Macek Jilkova ◽  
Komal Saleem ◽  
Samia Afzal ◽  
Thomas Decaens
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Predictive Factors ◽  
Antiviral Treatment ◽  
Direct Acting Antiviral ◽  
Chronic Hepatitis C Virus ◽  
Direct Acting

Chronic hepatitis C virus infection is still one of the major risk factors for the development of hepatocellular carcinoma (HCC), the most frequent type of primary liver cancer. Direct-acting antivirals have substantially improved the cure rate of the virus, but the risk of hepatitis C virus-related HCC remains high, mainly in patients with advanced liver fibrosis and cirrhosis. HCC is often asymptomatic and, therefore, remains undetected until the late tumor stage, which is associated with poor survival rates. Therefore, to improve the surveillance programs following HCV eradication, there is a need to summarize predictive factors or potential biomarkers, to specifically identify patients likely to develop HCC after direct-acting antiviral treatment. This review outlines the most recent data about different predictive factors for HCC development after direct-acting antiviral treatment of hepatitis C virus-infected patients, to improve the clinical management of patients with chronic hepatitis C virus.

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