Change in Fibrosis 4 Index as Predictor of High Risk of Incident Hepatocellular Carcinoma After Eradication of Hepatitis C Virus
| Autor: | Koji Joko, Rohit Loomba, Koichiro Furuta, Yutaka Yasui, Masayuki Kurosaki, Yuji Kojima, Hiroyuki Kimura, Masahiko Kondo, Chitomi Hasebe, Nami Mori, Haruhiko Kobashi, Namiki Izumi, Nobuharu Tamaki, Hideo Yoshida, Takehiro Akahane, Keiji Tsuji, Hitoshi Yagisawa, Hiroyuki Marusawa, Yasushi Uchida |
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| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
Sustained Virologic Response Liver fibrosis Hepacivirus medicine.disease_cause Gastroenterology Medical and Health Sciences Hepatitis Virological response 0302 clinical medicine Risk Factors Chronic Online only Articles Cancer Liver Disease Liver Neoplasms hepatocellular carcinoma Biological Sciences Hepatitis C Infectious Diseases 030220 oncology & carcinogenesis Hepatocellular carcinoma Cohort FIB-4 030211 gastroenterology & hepatology Microbiology (medical) Liver Cancer medicine.medical_specialty Carcinoma Hepatocellular SVR Hepatitis C virus Chronic Liver Disease and Cirrhosis Antiviral Agents Microbiology 03 medical and health sciences Rare Diseases Clinical Research Internal medicine medicine Humans In patient Fibrosis-4 index Antiviral treatment DAA business.industry Carcinoma Hepatocellular Hepatitis C Chronic medicine.disease digestive system diseases Good Health and Well Being business Digestive Diseases |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol 73, iss 9 Clin Infect Dis |
| Popis: | Background It is unclear whether the fibrosis 4 index (FIB-4), a marker of liver fibrosis, at baseline and change in FIB-4 after sustained virological response (SVR) is associated with incident hepatocellular carcinoma (HCC) risk. In this study, we examined the association of incident HCC risk with baseline FIB-4 and sustained high FIB-4 (>3.25) at any time point after SVR. Methods A total of 3823 patients who received direct-acting antiviral treatment and achieved SVR were enrolled. The FIB-4 was measured 24 weeks after the end of direct-acting antiviral treatment and achievement of SVR (SVR24), and 1, 2, and 3 years after SVR24, after which subsequent HCC development was investigated. Results In patients with an FIB-4 >3.25 at SVR24 and 1, 2, and 3 years after SVR24, subsequent HCC development was significantly higher than in those with an FIB-4 ≤3.25 at each point. The rates of HCC development 1, 2, 3, and 4 years after SVR24 were significantly higher in patients with sustained FIB-4 >3.25 than in those whose FIB-4 decreased to ≤3.25 (5.4%, 9.2%, 11.7%, and 16.0%, respectively, vs 2.2%, 3.1%, 3.7%, and 4.4%; P 3.25 at SVR24 and 1, 2, and 3 years later were 3.38 (2.4–4.8), 2.95 (1.9–4.7), 2.62 (1.3–5.1), and 3.37 (1.4–9.8), respectively. Conclusions The FIB-4 could be used to assess HCC development risk at any time after SVR, and changes in FIB-4 were associated with changes in the HCC development risk. Repeated assessments of FIB-4 could serve as a prognostic indicator of a high-risk HCC cohort that may require more intensive HCC surveillance strategy. |
| Databáze: | OpenAIRE |
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