Factors associated with hepatocellular carcinoma occurrence after HCV eradication in patients without cirrhosis or with compensated cirrhosis

PLoS One. 2020 Dec 7;15(12):e0243473. doi: 10.1371/journal.pone.0243473. eCollection 2020.

Abstract

The present study aimed to investigate the incidence of hepatocellular carcinoma (HCC) and factors related to HCC occurrence after direct-acting antiviral (DAA) treatment in the Fukushima Liver Academic Group (FLAG). We conducted a multicenter retrospective cohort study of 1068 patients without cirrhosis (NC) or with compensated liver cirrhosis (LC) who achieved a sustained virologic response (SVR). First, we compared the cumulative HCC incidence and survival rates in NC (n = 880) and LC (n = 188) patients without a history of HCC treatment. Second, we performed multivariate analysis of factors related to HCC occurrence after DAA treatment. Overall, the average age was 65 years, and the male/female ratio was 511/557. Thirty-nine (4%) patients developed HCC. The cumulative 4-year HCC incidence and survival rates were 3.0% and 99.8% in NC patients and 11.5% and 98.5% in LC patients, respectively. The independent factors affecting HCC occurrence identified by multivariate analysis were the serum albumin (ALB) level before SVR for NC patients and the ALBI score, platelet count, and diabetes before SVR for LC patients. The factors related to HCC occurrence differed between NC and LC patients. Careful surveillance of post-SVR patients with these risk factors is needed.

MeSH terms

  • Aged
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / epidemiology
  • Carcinoma, Hepatocellular / mortality
  • Diabetes Complications / pathology
  • Female
  • Genotype
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Neoplasms / complications
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / mortality
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin / analysis
  • Survival Rate
  • Sustained Virologic Response

Substances

  • Antiviral Agents
  • Serum Albumin

Grants and funding

Rai Clinic provided support in the form of salaries for authors TR and HS. Cosmos Clinic provided support in the form of salary for author JT. Funders did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the "author contributions" section.