Decrease of Alpha-fetoprotein in Patients with Cirrhosis Treated with Direct-acting Antivirals.

Autor:	Nguyen K; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA., Jimenez M; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., Moghadam N; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., Wu C; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., Farid A; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., Grotts J; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA., Elashoff D; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA.; Departments of Biostatistics, the University of California at Los Angeles, Los Angeles, CA, USA., Choi G; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA.; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., Durazo FA; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA.; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., El-Kabany MM; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA.; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., Han SB; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA.; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA., Saab S; Departments of Medicine, the University of California at Los Angeles, Los Angeles, CA, USA.; Departments of Surgery, the University of California at Los Angeles, Los Angeles, CA, USA.
Jazyk:	angličtina
Zdroj:	Journal of clinical and translational hepatology [J Clin Transl Hepatol] 2017 Mar 28; Vol. 5 (1), pp. 43-49. Date of Electronic Publication: 2017 Mar 08.
DOI:	10.14218/JCTH.2016.00057
Abstrakt:	Background and Aims: The lack of specificity has limited the role of serum alpha-fetoprotein (AFP) for hepatocellular carcinoma (HCC) screening among patients with cirrhosis related to hepatitis C virus (HCV) infection. We sought to examine whether AFP may decrease after achieving a sustained virological response (SVR) in patients with HCV-related cirrhosis. Methods: We performed a retrospective study of patients with HCV-related cirrhosis who were cured with direct-acting antiviral (DAA) therapy at the University of California, Los Angeles. Laboratory values, including serum AFP, were measured before and after completing the DAA treatment. Results: Fifty-six patients met the inclusion criteria, with median (interquartile range [IQR]) age of 67 (58-69) years and with 51.8% being male. All patients received DAA therapy without interferon. AFP decreased from median (IQR) 7.2 (4.2-13.4) ng/mL before DAAs to 4.2 (2.7-6.3) ng/mL at the end of treatment and 4.2 (2.9-6.8) ng/mL at 12 weeks after treatment ( p < 0.001). Model for end-stage liver disease (MELD), fibrosis-4 (FIB4), and aspartate transaminase (AST) to platelet ratio index (APRI) scores at baseline were not significantly associated with AFP reduction. On multivariate analysis, platelet count, AST and total bilirubin at baseline were significantly correlated to AFP reduction ( p = 0.04, 0.009 and 0.04, respectively). The higher the baseline AFP, the greater the reduction in AFP. There was no statistically significant correlation between baseline AFP and MELD, FIB4 or APRI scores. Conclusion: There was a significant decrease in AFP in patients with cirrhosis who achieved a SVR with DAAs. Given a reduction in AFP after DAA treatment, AFP should be further studied as a screening modality for HCC in patients with cirrhosis. Competing Interests: The authors have no conflict of interests related to this publication.
Databáze:	MEDLINE
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