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Clinical characteristics and prognosis of HCC occurrence after antiviral therapy for HCV patients between sustained and non-sustained responders.
J Formos Med Assoc. 2019 Jan; 118(1 Pt 3):504-513.JF

Abstract

BACKGROUND

Hepatitis C virus (HCV)-infected patients who achieved sustained virologic response (SVR) may still develop hepatocellular carcinoma (HCC). The characteristic of HCC and the prognosis between SVR and non-SVR patients were not well known.

METHODS

Among 1884 HCV-infected patients who were treated with pegylated IFN plus ribavirin therapies, 122 patients developed HCC during follow-up were enrolled in this study. Laboratory data were collected before and at least 1 year after IFN-based therapy, as well as the latest follow-up.

RESULTS

Both SVR and non-SVR patients had similar risk factors to develop HCC, but with a little difference. Liver cirrhosis plays a key role in HCC occurrence in both groups. Among the patients who developed HCC, non-SVR patients had significantly higher total bilirubin, higher FIB-4, lower pre-treatment platelet count, higher pre-treatment AFP levels and higher proportion of cirrhosis than SVR patients before occurrence of HCC. After curative treatment, SVR patients had lower recurrence and longer overall survival than non-SVR patients by Kaplan-Meier analysis. Multivariate analysis revealed that APRI ≥0.7 was the independent risk factor for HCC recurrence; and AFP ≥20 ng/ml post IFN therapy, as well as HCC recurrence were the independent risk factors of mortality.

CONCLUSION

Liver cirrhosis plays a key role in HCC occurrence after antiviral therapies. SVR patients may have lower HCC recurrence and longer survival rates than non-SVR patients. Only APRI was associated with HCC recurrence; and post-IFN AFP and HCC recurrence were predictive of subsequent mortality independently.

Authors+Show Affiliations

Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: dr.hu@msa.hinet.net.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30527565

Citation

Sou, Fai-Meng, et al. "Clinical Characteristics and Prognosis of HCC Occurrence After Antiviral Therapy for HCV Patients Between Sustained and Non-sustained Responders." Journal of the Formosan Medical Association = Taiwan Yi Zhi, vol. 118, no. 1 Pt 3, 2019, pp. 504-513.
Sou FM, Wu CK, Chang KC, et al. Clinical characteristics and prognosis of HCC occurrence after antiviral therapy for HCV patients between sustained and non-sustained responders. J Formos Med Assoc. 2019;118(1 Pt 3):504-513.
Sou, F. M., Wu, C. K., Chang, K. C., Lu, S. N., Wang, J. H., Hung, C. H., Chen, C. H., Kee, K. M., Yen, Y. H., Lin, M. T., Tsai, M. C., & Hu, T. H. (2019). Clinical characteristics and prognosis of HCC occurrence after antiviral therapy for HCV patients between sustained and non-sustained responders. Journal of the Formosan Medical Association = Taiwan Yi Zhi, 118(1 Pt 3), 504-513. https://doi.org/10.1016/j.jfma.2018.10.017
Sou FM, et al. Clinical Characteristics and Prognosis of HCC Occurrence After Antiviral Therapy for HCV Patients Between Sustained and Non-sustained Responders. J Formos Med Assoc. 2019;118(1 Pt 3):504-513. PubMed PMID: 30527565.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and prognosis of HCC occurrence after antiviral therapy for HCV patients between sustained and non-sustained responders. AU - Sou,Fai-Meng, AU - Wu,Cheng-Kun, AU - Chang,Kuo-Chin, AU - Lu,Sheng-Nan, AU - Wang,Jing-Houng, AU - Hung,Chao-Hung, AU - Chen,Chien-Hung, AU - Kee,Kwong-Ming, AU - Yen,Yi-Hao, AU - Lin,Ming-Tsung, AU - Tsai,Ming-Chao, AU - Hu,Tsung-Hui, Y1 - 2018/12/04/ PY - 2018/04/24/received PY - 2018/09/16/revised PY - 2018/10/25/accepted PY - 2018/12/12/pubmed PY - 2019/3/13/medline PY - 2018/12/12/entrez KW - Antiviral therapy KW - Hepatitis C virus KW - Hepatocellular carcinoma KW - Mortality KW - Recurrence SP - 504 EP - 513 JF - Journal of the Formosan Medical Association = Taiwan yi zhi JO - J. Formos. Med. Assoc. VL - 118 IS - 1 Pt 3 N2 - BACKGROUND: Hepatitis C virus (HCV)-infected patients who achieved sustained virologic response (SVR) may still develop hepatocellular carcinoma (HCC). The characteristic of HCC and the prognosis between SVR and non-SVR patients were not well known. METHODS: Among 1884 HCV-infected patients who were treated with pegylated IFN plus ribavirin therapies, 122 patients developed HCC during follow-up were enrolled in this study. Laboratory data were collected before and at least 1 year after IFN-based therapy, as well as the latest follow-up. RESULTS: Both SVR and non-SVR patients had similar risk factors to develop HCC, but with a little difference. Liver cirrhosis plays a key role in HCC occurrence in both groups. Among the patients who developed HCC, non-SVR patients had significantly higher total bilirubin, higher FIB-4, lower pre-treatment platelet count, higher pre-treatment AFP levels and higher proportion of cirrhosis than SVR patients before occurrence of HCC. After curative treatment, SVR patients had lower recurrence and longer overall survival than non-SVR patients by Kaplan-Meier analysis. Multivariate analysis revealed that APRI ≥0.7 was the independent risk factor for HCC recurrence; and AFP ≥20 ng/ml post IFN therapy, as well as HCC recurrence were the independent risk factors of mortality. CONCLUSION: Liver cirrhosis plays a key role in HCC occurrence after antiviral therapies. SVR patients may have lower HCC recurrence and longer survival rates than non-SVR patients. Only APRI was associated with HCC recurrence; and post-IFN AFP and HCC recurrence were predictive of subsequent mortality independently. SN - 0929-6646 UR - https://www.unboundmedicine.com/medline/citation/30527565/Clinical_characteristics_and_prognosis_of_HCC_occurrence_after_antiviral_therapy_for_HCV_patients_between_sustained_and_non_sustained_responders_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-6646(18)30274-2 DB - PRIME DP - Unbound Medicine ER -