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Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index.
Gut Liver. 2016 Sep 15; 10(5):796-802.GL

Abstract

BACKGROUND/AIMS

Following sustained virological response (SVR) for chronic hepatitis C (CHC) infection, patients with advanced fibrosis require regular monitoring for hepatocellular carcinoma (HCC). The aspartate aminotransferase to platelet ratio index (APRI) is a simple noninvasive surrogate marker known to reflect fibrosis.

METHODS

We retrospectively analyzed 598 patients who achieved SVR with interferonbased therapy for CHC.

RESULTS

Over a median of 5.1 years of follow-up, there were eight patients diagnosed with HCC and a 5-year cumulative incidence rate of 1.3%. The median pretreatment APRI was 0.83, which decreased to 0.29 after achieving SVR (p<0.001). Both the pre- and posttreatment indices were associated with HCC development. The 5-year cumulative HCC incidence rates were 0% and 2.8% for patients with pretreatment APRI <1.0 and ≥1.0, respectively (p=0.001) and 0.8% and 12.8% for patients with posttreatment APRI <1.0 and ≥1.0, respectively (p<0.001). Pretreatment APRI at a cutoff of 1.0 had a 100% negative predictive value until 10 years after SVR.

CONCLUSIONS

HCC development was observed among CHC patients who achieved SVR. The pre- and post-treatment APRI could stratify HCC risk, indicating that the APRI could be a useful marker to classify HCC risk in CHC patients who achieved SVR. However, given the small number of HCC patients, this finding warrants further validation.

Authors+Show Affiliations

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27114418

Citation

Lee, Keol, et al. "Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients After Sustained Virological Response By Aspartate Aminotransferase to Platelet Ratio Index." Gut and Liver, vol. 10, no. 5, 2016, pp. 796-802.
Lee K, Sinn DH, Gwak GY, et al. Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index. Gut Liver. 2016;10(5):796-802.
Lee, K., Sinn, D. H., Gwak, G. Y., Cho, H. C., Jung, S. H., Paik, Y. H., Choi, M. S., Lee, J. H., Koh, K. C., & Paik, S. W. (2016). Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index. Gut and Liver, 10(5), 796-802. https://doi.org/10.5009/gnl15368
Lee K, et al. Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients After Sustained Virological Response By Aspartate Aminotransferase to Platelet Ratio Index. Gut Liver. 2016 Sep 15;10(5):796-802. PubMed PMID: 27114418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index. AU - Lee,Keol, AU - Sinn,Dong Hyun, AU - Gwak,Geum-Youn, AU - Cho,Hyun Chin, AU - Jung,Sin-Ho, AU - Paik,Yong-Han, AU - Choi,Moon Seok, AU - Lee,Joon Hyeok, AU - Koh,Kwang Cheol, AU - Paik,Seung Woon, PY - 2015/08/02/received PY - 2015/11/01/revised PY - 2015/11/01/accepted PY - 2016/4/27/entrez PY - 2016/4/27/pubmed PY - 2017/7/28/medline KW - Aspartate aminotransferase to platelet ratio index KW - Carcinoma KW - Hepatitis C KW - Sustained virological response KW - chronic KW - hepatocellular SP - 796 EP - 802 JF - Gut and liver JO - Gut Liver VL - 10 IS - 5 N2 - BACKGROUND/AIMS: Following sustained virological response (SVR) for chronic hepatitis C (CHC) infection, patients with advanced fibrosis require regular monitoring for hepatocellular carcinoma (HCC). The aspartate aminotransferase to platelet ratio index (APRI) is a simple noninvasive surrogate marker known to reflect fibrosis. METHODS: We retrospectively analyzed 598 patients who achieved SVR with interferonbased therapy for CHC. RESULTS: Over a median of 5.1 years of follow-up, there were eight patients diagnosed with HCC and a 5-year cumulative incidence rate of 1.3%. The median pretreatment APRI was 0.83, which decreased to 0.29 after achieving SVR (p<0.001). Both the pre- and posttreatment indices were associated with HCC development. The 5-year cumulative HCC incidence rates were 0% and 2.8% for patients with pretreatment APRI <1.0 and ≥1.0, respectively (p=0.001) and 0.8% and 12.8% for patients with posttreatment APRI <1.0 and ≥1.0, respectively (p<0.001). Pretreatment APRI at a cutoff of 1.0 had a 100% negative predictive value until 10 years after SVR. CONCLUSIONS: HCC development was observed among CHC patients who achieved SVR. The pre- and post-treatment APRI could stratify HCC risk, indicating that the APRI could be a useful marker to classify HCC risk in CHC patients who achieved SVR. However, given the small number of HCC patients, this finding warrants further validation. SN - 2005-1212 UR - https://www.unboundmedicine.com/medline/citation/27114418/Prediction_of_the_Risk_of_Hepatocellular_Carcinoma_in_Chronic_Hepatitis_C_Patients_after_Sustained_Virological_Response_by_Aspartate_Aminotransferase_to_Platelet_Ratio_Index_ L2 - http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl15368 DB - PRIME DP - Unbound Medicine ER -