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Aspartate aminotransferase to platelet ratio index and sustained virologic response are associated with progression from hepatitis C associated liver cirrhosis to hepatocellular carcinoma after treatment with pegylated interferon plus ribavirin.
Clin Interv Aging. 2016; 11:1035-41.CI

Abstract

BACKGROUND

The aim of this study was to evaluate the clinically significant predictors of hepatocellular carcinoma (HCC) development among hepatitis C virus (HCV) cirrhotic patients receiving combination therapy.

PATIENTS AND METHODS

One hundred and five compensated cirrhosis patients who received pegylated interferon plus ribavirin between January 2005 and December 2011 were enrolled. All the patients were examined with abdominal sonography and liver biochemistry at baseline, end of treatment, and every 3-6 months posttreatment. The occurrence of HCC was evaluated every 3-6 months posttreatment.

RESULTS

A total of 105 patients were enrolled (mean age 58.3±10.4 years). The average follow-up time for each patient was 4.38 years (standard deviation 1.73 years; range 1.13-9.27 years). Fifteen (14.3%) patients developed HCC during follow-up period. Thirteen of them had high baseline aspartate aminotransferase to platelet ratio index (APRI) (ie, an APRI >2.0). Multivariate analysis showed that those without sustained virologic response (SVR) (hazard ratio [HR] 5.795; 95% confidence interval [CI] 1.370-24.5; P=0.017) and high APRI (HR 5.548; 95% CI 1.191-25.86; P=0.029) had a significantly higher risk of HCC occurrence. The cumulative incidence of HCC was significantly higher (P=0.009) in patients without SVR (3-year cumulative incidence 21.4%; 95% CI 7.4%-35.5%; 5-year cumulative incidence 31.1%; 95% CI 11.2%-51.1%) compared to those with SVR (3- and 5-year cumulative incidence 6.2%; 95% CI 0%-1.3%). Further, the cumulative incidence of HCC was significantly higher (P=0.006) in patients with high APRI (3-year cumulative incidence 21.8%; 95% CI 8.2%-35.3%; 5-year cumulative incidence 30.5%, 95% CI 11.8%-49.3%) compared to those with low APRI (3- and 5-year cumulative incidence 4.2%, 95% CI 0%-1.0%).

CONCLUSION

In HCV-infected cirrhotic patients who received combination therapy, APRI and SVR are the two major predictors of HCC development.

Authors+Show Affiliations

Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi; School of Medicine, Tzu Chi University, Hualien.Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi; School of Medicine, Tzu Chi University, Hualien; Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei; School of Medicine, National Yang-Ming University, Taipei.Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Tainan; Infectious Disease and Signaling Research Center, National Cheng Kung University, Tainan.Department of Agronomy, National Chiayi University, Chia-Yi.Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi; School of Medicine, Tzu Chi University, Hualien.Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi; School of Medicine, Tzu Chi University, Hualien.Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi.Institute of Molecular Biology, National Chung Cheng University, Chia-Yi, Taiwan.Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi; School of Medicine, Tzu Chi University, Hualien.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27536084

Citation

Ng, Khai-Jing, et al. "Aspartate Aminotransferase to Platelet Ratio Index and Sustained Virologic Response Are Associated With Progression From Hepatitis C Associated Liver Cirrhosis to Hepatocellular Carcinoma After Treatment With Pegylated Interferon Plus Ribavirin." Clinical Interventions in Aging, vol. 11, 2016, pp. 1035-41.
Ng KJ, Tseng CW, Chang TT, et al. Aspartate aminotransferase to platelet ratio index and sustained virologic response are associated with progression from hepatitis C associated liver cirrhosis to hepatocellular carcinoma after treatment with pegylated interferon plus ribavirin. Clin Interv Aging. 2016;11:1035-41.
Ng, K. J., Tseng, C. W., Chang, T. T., Tzeng, S. J., Hsieh, Y. H., Hung, T. H., Huang, H. T., Wu, S. F., & Tseng, K. C. (2016). Aspartate aminotransferase to platelet ratio index and sustained virologic response are associated with progression from hepatitis C associated liver cirrhosis to hepatocellular carcinoma after treatment with pegylated interferon plus ribavirin. Clinical Interventions in Aging, 11, 1035-41. https://doi.org/10.2147/CIA.S108589
Ng KJ, et al. Aspartate Aminotransferase to Platelet Ratio Index and Sustained Virologic Response Are Associated With Progression From Hepatitis C Associated Liver Cirrhosis to Hepatocellular Carcinoma After Treatment With Pegylated Interferon Plus Ribavirin. Clin Interv Aging. 2016;11:1035-41. PubMed PMID: 27536084.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aspartate aminotransferase to platelet ratio index and sustained virologic response are associated with progression from hepatitis C associated liver cirrhosis to hepatocellular carcinoma after treatment with pegylated interferon plus ribavirin. AU - Ng,Khai-Jing, AU - Tseng,Chih-Wei, AU - Chang,Ting-Tsung, AU - Tzeng,Shinn-Jia, AU - Hsieh,Yu-Hsi, AU - Hung,Tsung-Hsing, AU - Huang,Hsiang-Ting, AU - Wu,Shu-Fen, AU - Tseng,Kuo-Chih, Y1 - 2016/08/01/ PY - 2016/8/19/entrez PY - 2016/8/19/pubmed PY - 2017/2/14/medline KW - aspartate aminotransferase to platelet ratio index KW - chronic hepatitis C KW - hepatitis C virus KW - hepatocellular carcinoma KW - liver cirrhosis KW - sustained virologic response SP - 1035 EP - 41 JF - Clinical interventions in aging JO - Clin Interv Aging VL - 11 N2 - BACKGROUND: The aim of this study was to evaluate the clinically significant predictors of hepatocellular carcinoma (HCC) development among hepatitis C virus (HCV) cirrhotic patients receiving combination therapy. PATIENTS AND METHODS: One hundred and five compensated cirrhosis patients who received pegylated interferon plus ribavirin between January 2005 and December 2011 were enrolled. All the patients were examined with abdominal sonography and liver biochemistry at baseline, end of treatment, and every 3-6 months posttreatment. The occurrence of HCC was evaluated every 3-6 months posttreatment. RESULTS: A total of 105 patients were enrolled (mean age 58.3±10.4 years). The average follow-up time for each patient was 4.38 years (standard deviation 1.73 years; range 1.13-9.27 years). Fifteen (14.3%) patients developed HCC during follow-up period. Thirteen of them had high baseline aspartate aminotransferase to platelet ratio index (APRI) (ie, an APRI >2.0). Multivariate analysis showed that those without sustained virologic response (SVR) (hazard ratio [HR] 5.795; 95% confidence interval [CI] 1.370-24.5; P=0.017) and high APRI (HR 5.548; 95% CI 1.191-25.86; P=0.029) had a significantly higher risk of HCC occurrence. The cumulative incidence of HCC was significantly higher (P=0.009) in patients without SVR (3-year cumulative incidence 21.4%; 95% CI 7.4%-35.5%; 5-year cumulative incidence 31.1%; 95% CI 11.2%-51.1%) compared to those with SVR (3- and 5-year cumulative incidence 6.2%; 95% CI 0%-1.3%). Further, the cumulative incidence of HCC was significantly higher (P=0.006) in patients with high APRI (3-year cumulative incidence 21.8%; 95% CI 8.2%-35.3%; 5-year cumulative incidence 30.5%, 95% CI 11.8%-49.3%) compared to those with low APRI (3- and 5-year cumulative incidence 4.2%, 95% CI 0%-1.0%). CONCLUSION: In HCV-infected cirrhotic patients who received combination therapy, APRI and SVR are the two major predictors of HCC development. SN - 1178-1998 UR - https://www.unboundmedicine.com/medline/citation/27536084/Aspartate_aminotransferase_to_platelet_ratio_index_and_sustained_virologic_response_are_associated_with_progression_from_hepatitis_C_associated_liver_cirrhosis_to_hepatocellular_carcinoma_after_treatment_with_pegylated_interferon_plus_ribavirin_ L2 - https://dx.doi.org/10.2147/CIA.S108589 DB - PRIME DP - Unbound Medicine ER -