The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents
Abstract
BACKGROUND & AIMS Studies have produced conflicting results of the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis C virus-associated cirrhosis treated with direct-acting antivirals (DAAs). Data from clinics are needed to accurately assess the occurrence rate of HCC in patients with cirrhosis in the real world. METHODS We collected data from a large prospective study of 2,249 consecutive patients (mean age = 65.4 years, 56.9% male) with hepatitis C virus-associated cirrhosis (90.5% with Child-Pugh class A and 9.5% with Child-Pugh class B) treated with DAAs from March 2015 through July 2016 at 22 academic and community liver centers in Sicily, Italy. HCC occurrence was evaluated by Kaplan-Meier curves. Cox regression analysis was used to identify variables associated with HCC development. RESULTS A sustained virologic response (SVR) was achieved by 2,140 patients (total = 95.2%; 95.9% with Child Pugh class A and 88.3% with Child Pugh class B; P < .001). Seventy-eight patients (3.5%) developed HCC during a mean follow-up of 14 months (range = 6-24 months). At 1 year after exposure to DAAs, HCC developed in 2.1% of patients with Child-Pugh class A with an SVR and 6.6% of patients with no SVR and in 7.8% of patients with Child-Pugh class B with an SVR and 12.4% of patients with no SVR (P < .001 by log-rank test). Albumin level below 3.5 g/dL (hazard ratio = 1.77, 95% confidence interval = 1.12-2.82, P = .015), platelet count below 120 × 109/L (hazard ratio = 3.89, 95% confidence interval = 2.11-7.15, P < .001), and absence of an SVR (hazard ratio = 3.40, 95% confidence interval = 1.89-6.12, P < .001) were independently associated increased risk for HCC. The mean interval from exposure to DAAs to an HCC diagnosis was 9.8 months (range = 2-22 months) and did not differ significantly between patients with (n = 64, 9.2 months) and without (n = 14, 12.0 months) an SVR (P = .11). A larger proportion of patients with an SVR had a single HCC lesion (78% vs 50% without an SVR; P = .009) or an HCC lesion smaller than 3 cm (58% vs 28% without an SVR; P = .07). CONCLUSIONS In an analysis of data from a large prospective study of patients with hepatitis C virus-associated compensated or decompensated cirrhosis, we found that the SVR to DAA treatment decreased the incidence of HCC over a mean follow-up of 14 months.
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Cites
Expanding consensus in portal hypertension
de Franchis, R. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.05.022 · Cited by 3,078
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Pawlotsky, J.-M., Negro, F., Aghemo, A., Berenguer, M., Dalgard, O., Dusheiko, G., Marra, F., Puoti, M., & Wedemeyer, H. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.03.026 · Cited by 2,827
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Risk of Hepatocellular Cancer in HCV Patients Treated With Direct-Acting Antiviral Agents
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Oral Direct-Acting Agent Therapy for Hepatitis C Virus Infection: A Systematic Review
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Berzigotti, A., Tsochatzis, E., Boursier, J., Castera, L., Cazzagon, N., Friedrich-Rust, M., Petta, S., & Thiele, M. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.05.025 · Cited by 1,925
Self-citationEASL recommendations on treatment of hepatitis C: Final update of the series☆
Pawlotsky, J.-M., Negro, F., Aghemo, A., Berenguer, M., Dalgard, O., Dusheiko, G., Marra, F., Puoti, M., & Wedemeyer, H. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.08.018 · Cited by 1,252
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Metadata
- Authors
- Calvaruso, V., Cabibbo, G., Cacciola, I., Petta, S., Madonia, S., Bellia, A., Tinè, F., Distefano, M., Licata, A., Giannitrapani, L., Prestileo, T., Mazzola, G., Di Rosolini, M. A., Larocca, L., Bertino, G., Digiacomo, A., Benanti, F., Guarneri, L., Averna, A., Iacobello, C., Magro, A., Scalisi, I., Cartabellotta, F., Savalli, F., Barbara, M., Davì, A., Russello, M., Scifo, G., Squadrito, G., Cammà, C., Raimondo, G., Craxì, A., Di Marco, V., Craxì, A., Di Marco, V., Cammà, C., Calvaruso, V., Petta, S., Cabbibbo, G., Colletti, P., Mazzola, G., Cascio, A., Montalto, G., Licata, A., Giannitrapani, L., Prestileo, T., Di Lorenzo, F., Sanfilippo, A., Ficalora, A., Madonia, S., Tinè, F., Malizia, G., Latteri, F., Maida, M., Cartabellotta, F., Vassallo, R., Cacciola, I., Caccamo, G., Maimone, S., Saitta, C., Squadrito, G., Raimondo, G., Mondello, L., Smedile, A., D’Andrea, S., Bertino, G., Ardiri, A. L., Frazzetto, E., Rigano, G., Montineri, A., Larocca, L. N., Cacopardo, B., Benanti, F., Russello, M., Benigno, R., Bellia, A., Iacobello, C., Davì, A., Di Rosolini, M. A., Digiacomo, A., Fuduli, G., Scifo, G., Distefano, M., Portelli, V., Savalli, F., Scalici, I., Gioia, G., Magro, A., Alaimo, G., Alinovi, M. R., Salvo, A., Averna, A., Lomonaco, F., Guarneri, L., Maffeo, F., Falzone, E., & Pulvirenti, F.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 155
- Issue
- 2
- Pages
- 411-421.e4
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2797952741
- Cited by
- 361
- References
- 34
- FWCI
- 30.00
- Type
- journal article
- Language
- en
- Open access
- closed
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- Calvaruso, V., Cabibbo, G., Cacciola, I., Petta, S., Madonia, S., Bellia, A., Tinè, F., Distefano, M., Licata, A., Giannitrapani, L., Prestileo, T., Mazzola, G., Di Rosolini, M. A., Larocca, L., Bertino, G., Digiacomo, A., Benanti, F., Guarneri, L., Averna, A., . . . Pulvirenti, F. (2018). Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents. Gastroenterology. https://doi.org/10.1053/j.gastro.2018.04.008
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