Simple Stratification of Hepatocellular Carcinoma Surveillance after Direct-acting Antiviral Therapy for Chronic Hepatitis C

DOI IR Web Site 26 References
  • WANG Tianpeng
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • SAKAKI Masashi
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • ICHIKAWA Yuki
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • OTOYAMA Yumi
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • NAKAJIMA Yoko
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • SUGIURA Ikuya
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • ARAI Jun
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • KAJIWARA Atsushi
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • UOZUMI Shojiro
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • SHIMOZUMA Yuu
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • UCHIKOSHI Manabu
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine
  • YOSHIDA Hitoshi
    Department of Medicine, Division of Gastroenterology, Showa University School of Medicine

Search this article

Abstract

Reports on surveillance systems useful for determining the risk of developing hepatocellular carcinoma （HCC） after direct-acting antiviral （DAA） treatment for hepatitis C have been published. Liver cirrhosis （LC） is a high-risk factor for HCC, but the evaluation frequency necessary for patients with chronic hepatitis （CH） remains unknown. Here, we aimed to identify how frequent CH patients should be evaluated for HCC, with particular emphasis on patients achieving a sustained virological response （SVR） with DAA treatment. Data were collected pre-treatment （Pre） and at the time of SVR for 141 patients with hepatitis C receiving DAA treatment. We defined LC by a platelet （PLT） count ≤10×104/µl, and CH was defined by a PLT count of ＞10×104/µl. The incidence of HCC in patients with CH after achieving SVR was retrospectively evaluated. In total, 128 patients （CH, n＝102; LC, n＝26） achieved SVR, and 13 developed HCC after SVR during the follow-up period （mean, 748 days）. Although fibrosis-4 （FIB-4） index, the presence of α-fetoprotein, and prothrombin time were significant risk factors for HCC in patients with CH in the univariate analysis, only the Pre-FIB-4 index was an independent predictive factor for HCC development in the multivariate analysis （p＝0.04）. An FIB-4 index ≥3 was a significant risk factor for HCC （p＝0.005）. The cumulative risk for HCC at 1000 days was 2.6％ and 24.2％ in the FIB-4 index ＜3 and FIB-4 index ≥3 groups, respectively （p＝0.004）. Frequent HCC examination is recommended for FIB-4 index ≥3 CH patients who obtain SVR after DAA treatment.

Journal

References(26)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top