PLoS ONE (Jan 2022)

Features of patients who developed hepatocellular carcinoma after direct-acting antiviral treatment for hepatitis C Virus

  • Seiichi Mawatari,
  • Kotaro Kumagai,
  • Kohei Oda,
  • Kazuaki Tabu,
  • Sho Ijuin,
  • Kunio Fujisaki,
  • Shuzo Tashima,
  • Yukiko Inada,
  • Hirofumi Uto,
  • Akiko Saisyoji,
  • Yasunari Hiramine,
  • Masafumi Hashiguchi,
  • Tsutomu Tamai,
  • Takeshi Hori,
  • Ohki Taniyama,
  • Ai Toyodome,
  • Haruka Sakae,
  • Takeshi Kure,
  • Kazuhiro Sakurai,
  • Akihiro Moriuchi,
  • Shuji Kanmura,
  • Akio Ido

Journal volume & issue
Vol. 17, no. 1

Abstract

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Background The features of hepatitis C virus patients with a sustained virologic response (SVR) who developed hepatocellular carcinoma (HCC) after direct-acting antiviral (DAA) therapy are unclear. Methods The study population included 1494 DAA-SVR patients without a history of HCC. The cumulative carcinogenesis rate after the end of treatment (EOT) and factors related to HCC were analyzed. Results Sixty (4.0%) patients developed HCC during a median observation period of 47.6 months. At four years, the cumulative carcinogenesis rate was 4.7%. A Cox proportional hazards analysis showed that age ≥73 years (hazard ratio [HR]: 2.148), male sex (HR: 3.060), hyaluronic acid (HA) ≥75 ng/mL (HR: 3.996), alpha-fetoprotein at EOT (EOT-AFP) ≥5.3 ng/mL (HR: 4.773), and albumin at EOT (EOT-Alb) Conclusions EOT-AFP ≥5.3 ng/mL is useful for predicting HCC development after an SVR. However, AFP does not increase in patients with EOT-AFP <5.3 ng/mL at the onset of HCC. The combination of EOT-AFP, age, sex, HA, and EOT-Alb is important for predicting carcinogenesis.