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Risk factors of hepatocellular carcinoma development in non-cirrhotic patients with sustained virologic response for chronic hepatitis C virus infection.
J Gastroenterol Hepatol. 2015 Jul; 30(7):1183-9.JG

Abstract

BACKGROUND AND AIM

Hepatocellular carcinoma (HCC) can develop in patients with chronic hepatitis C after they have achieved a sustained virologic response (SVR) to antiviral therapy, that is eradication of hepatitis C virus (HCV). Thus, surveillance for HCC remains necessary after SVR. We investigated factors that are predictive of HCC in HCV-infected patients who achieved SVR.

METHODS

The incidence and risk factors for HCC were evaluated in 522 patients who achieved SVR with interferon-based antiviral therapy for HCV. Patients maintained regular follow-up every 6 months for HCC surveillance. The FIB-4 index and aspartate aminotransferase to platelet count ratio index were calculated based on laboratory data at the time that SVR was documented (SVR24).

RESULTS

Patients continued follow-up visits for 1.0-22.9 years (median, 7.2 years) after SVR. HCC developed in 18 patients. The incidence of HCC was 1.2% at 5 years and 4.3% at 10 years. The use of peginterferon or ribavirin for treatment and a history of antiviral therapy prior to the course when SVR was achieved were not associated with the incidence of HCC after SVR. The presence of diabetes mellitus (risk ratio 2.08; P = 0.0451) and FIB-4 index calculated at the time of SVR24 (risk ratio 1.73; P = 0.0198) were associated with a higher likelihood of HCC after SVR by multivariate analysis.

CONCLUSIONS

Patients with diabetes mellitus and patients with the elevation of FIB-4 index at SVR24 are at higher risk of HCC after SVR. Surveillance for HCC should be continued in this patient subpopulation.

Authors+Show Affiliations

Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25678094

Citation

Toyoda, Hidenori, et al. "Risk Factors of Hepatocellular Carcinoma Development in Non-cirrhotic Patients With Sustained Virologic Response for Chronic Hepatitis C Virus Infection." Journal of Gastroenterology and Hepatology, vol. 30, no. 7, 2015, pp. 1183-9.
Toyoda H, Kumada T, Tada T, et al. Risk factors of hepatocellular carcinoma development in non-cirrhotic patients with sustained virologic response for chronic hepatitis C virus infection. J Gastroenterol Hepatol. 2015;30(7):1183-9.
Toyoda, H., Kumada, T., Tada, T., Kiriyama, S., Tanikawa, M., Hisanaga, Y., Kanamori, A., Kitabatake, S., & Ito, T. (2015). Risk factors of hepatocellular carcinoma development in non-cirrhotic patients with sustained virologic response for chronic hepatitis C virus infection. Journal of Gastroenterology and Hepatology, 30(7), 1183-9. https://doi.org/10.1111/jgh.12915
Toyoda H, et al. Risk Factors of Hepatocellular Carcinoma Development in Non-cirrhotic Patients With Sustained Virologic Response for Chronic Hepatitis C Virus Infection. J Gastroenterol Hepatol. 2015;30(7):1183-9. PubMed PMID: 25678094.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors of hepatocellular carcinoma development in non-cirrhotic patients with sustained virologic response for chronic hepatitis C virus infection. AU - Toyoda,Hidenori, AU - Kumada,Takashi, AU - Tada,Toshifumi, AU - Kiriyama,Seiki, AU - Tanikawa,Makoto, AU - Hisanaga,Yasuhiro, AU - Kanamori,Akira, AU - Kitabatake,Shusuke, AU - Ito,Takanori, PY - 2015/01/25/accepted PY - 2015/2/14/entrez PY - 2015/2/14/pubmed PY - 2016/4/5/medline KW - antiviral therapy KW - chronic hepatitis C KW - hepatocellular carcinoma KW - risk factors KW - sustained virologic response SP - 1183 EP - 9 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 30 IS - 7 N2 - BACKGROUND AND AIM: Hepatocellular carcinoma (HCC) can develop in patients with chronic hepatitis C after they have achieved a sustained virologic response (SVR) to antiviral therapy, that is eradication of hepatitis C virus (HCV). Thus, surveillance for HCC remains necessary after SVR. We investigated factors that are predictive of HCC in HCV-infected patients who achieved SVR. METHODS: The incidence and risk factors for HCC were evaluated in 522 patients who achieved SVR with interferon-based antiviral therapy for HCV. Patients maintained regular follow-up every 6 months for HCC surveillance. The FIB-4 index and aspartate aminotransferase to platelet count ratio index were calculated based on laboratory data at the time that SVR was documented (SVR24). RESULTS: Patients continued follow-up visits for 1.0-22.9 years (median, 7.2 years) after SVR. HCC developed in 18 patients. The incidence of HCC was 1.2% at 5 years and 4.3% at 10 years. The use of peginterferon or ribavirin for treatment and a history of antiviral therapy prior to the course when SVR was achieved were not associated with the incidence of HCC after SVR. The presence of diabetes mellitus (risk ratio 2.08; P = 0.0451) and FIB-4 index calculated at the time of SVR24 (risk ratio 1.73; P = 0.0198) were associated with a higher likelihood of HCC after SVR by multivariate analysis. CONCLUSIONS: Patients with diabetes mellitus and patients with the elevation of FIB-4 index at SVR24 are at higher risk of HCC after SVR. Surveillance for HCC should be continued in this patient subpopulation. SN - 1440-1746 UR - https://www.unboundmedicine.com/medline/citation/25678094/Risk_factors_of_hepatocellular_carcinoma_development_in_non_cirrhotic_patients_with_sustained_virologic_response_for_chronic_hepatitis_C_virus_infection_ L2 - https://doi.org/10.1111/jgh.12915 DB - PRIME DP - Unbound Medicine ER -