scholarly journals Impact of Obesity and Heavy Alcohol Consumption on Hepatocellular Carcinoma Development after HCV Eradication with Antivirals

Liver Cancer ◽  
2021 ◽  
pp. 1-11
Author(s):  
Tatsuya Minami ◽  
Ryosuke Tateishi ◽  
Naoto Fujiwara ◽  
Ryo Nakagomi ◽  
Takuma Nakatsuka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Alcohol Consumption ◽  
Chronic Hepatitis C ◽  
Incidence Rates ◽  
Multicenter Cohort Study ◽  
Heavy Alcohol ◽  
Heavy Alcohol Consumption

<b><i>Background and Aims:</i></b> It remains unclear whether obesity increases the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C who achieved a sustained virological response (SVR) with antiviral therapy. <b><i>Methods:</i></b> In this multicenter cohort study, we enrolled patients with chronic hepatitis C who achieved SVR with interferon (IFN)-based therapy (IFN group) or direct-acting antiviral (DAA) therapy (DAA group) between January 1, 1990, and December 31, 2018. The patients underwent regular surveillance for HCC. Cumulative incidence of and the risk factors for HCC development after SVR were assessed using the Kaplan-Meier method and Cox proportional hazard regression analysis, respectively. <b><i>Results:</i></b> Among 2,055 patients (840 in the IFN group and 1,215 in the DAA group), 75 developed HCC (41 in the IFN group and 34 in the DAA group) during the mean observation period of 4.1 years. The incidence rates of HCC at 1, 2, and 3 years were 1.2, 1.9, and 3.0%, respectively. Multivariate analysis revealed that in addition to older age, lower albumin level, lower platelet count, higher alpha-fetoprotein level, and absence of dyslipidemia, obesity (body mass index ≥25 kg/m<sup>2</sup>) and heavy alcohol consumption (≥60 g/day) were independent risk factors for HCC development, with adjusted hazard ratio (HR) of 2.53 (95% confidence interval [CI]: 1.51–4.25) and 2.56 (95% CI: 1.14–5.75), respectively. The adjusted HR was not significant between the 2 groups (DAA vs. IFN; HR 1.19, 95% CI: 0.61–2.33). <b><i>Conclusions:</i></b> Obesity and heavy alcohol consumption increased the risk of HCC development after SVR.

scholarly journals Incidence of Hepatocellular Carcinoma after Treatment with Sofosbuvir-Based or Sofosbuvir-Free Regimens in Patients with Chronic Hepatitis C

Cancers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2602 ◽  
Author(s):  
Eiichi Ogawa ◽  
Hideyuki Nomura ◽  
Makoto Nakamuta ◽  
Norihiro Furusyo ◽  
Eiji Kajiwara ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
De Novo ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Multicenter Cohort Study ◽  
History Of ◽  
Direct Acting

Advanced fibrosis/cirrhosis and related biomarkers have been recognized as useful predictors of the development of hepatocellular carcinoma (HCC) by patients with chronic hepatitis C (CHC) following hepatitis C virus (HCV) cure by direct-acting antivirals (DAAs). However, it remains unclear if DAAs themselves have an influence on or facilitate the development of HCC. This multicenter cohort study included CHC patients without a history of HCC who achieved HCV elimination by DAAs. Cohorts of 835 patients treated with a sofosbuvir (SOF)-based regimen and 835 treated with a SOF-free regimen were matched 1:1 by propensity scoring with nine variables to evaluate differences in HCC incidence. The median observation period was 3.5 years. Sixty-nine cases of HCC were found during 5483.9 person-years (PY) over the entire follow-up period. The annual incidence was similar for both groups (SOF-based 1.25 and SOF-free 1.27 per 100 PY, respectively: adjusted hazard ratio (HR) 1.26, 95% confidence interval (CI) 0.75–2.12, p = 0.39). However, the annual incidence within the first two years was higher for patients treated with SOF than for those without, but did not reach significance (1.50 and 0.97 per 100 PY incidence rates, respectively: adjusted HR 2.05, 95% CI 0.98–4.25, p = 0.06). In summary, DAA treatment with SOF was not associated with an increase in the development of de novo HCC.

Risk Factors of Hepatocellular Carcinoma in Chronic Hepatitis C and Cirrhosis: Special Reference to Laparoscopic Findings

1999 ◽  
Vol 11 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Takao SHIBAYAMA ◽  
Shin‐iciro MORI ◽  
Hiroo OHTAKE ◽  
Seishuu HAYASHI ◽  
Shunichi SAEKI ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Special Reference ◽  
Chronic Hepatitis C

Risk factors for development of hepatocellular carcinoma in patients with chronic hepatitis C after sustained response to interferon

2005 ◽  
Vol 40 (2) ◽  
pp. 148-156 ◽  
Author(s):  
Masafumi Ikeda ◽  
Shigetoshi Fujiyama ◽  
Motohiko Tanaka ◽  
Michio Sata ◽  
Tatsuya Ide ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Sustained Response

scholarly journals Patients with Chronic Hepatitis C - Who Should Not Be Treated?

2000 ◽  
Vol 14 (suppl b) ◽  
pp. 63B-67B
Author(s):  
Andreas Schüler ◽  
Michael Peter Manns
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Treatment Side Effects ◽  
Life Conditions ◽  
Therapy Effectiveness ◽  
Receive Treatment

The decision to treat a patient with chronic hepatitis C (CHC) is based on what is known about the risk factors for developing liver cirrhosis or hepatocellular carcinoma, as well as on conditions that contraindicate therapy or impair therapy effectiveness. Several factors, including age, treatment side effects, disease severity, concurrent diseases and life conditions, may render treatment decisions more difficult. This review focuses on identifying CHC patients who should not receive treatment.

scholarly journals The Incidence of Hepatocellular Carcinoma Is not Increased in Individuals with Chronic Hepatitis C After Treatment with Interferon-free Regimens: an ERCHIVES Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S41-S41 ◽  
Author(s):  
Darrick K Li ◽  
Yanjie Ren ◽  
Obaid Saikh ◽  
Daniel S Fierer ◽  
Vincent Lo Re ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Smoking History ◽  
Free Survival ◽  
Increased Risk ◽  
Ifn Treatment ◽  
Research Grant

Abstract Background Sustained virologic response (SVR) after interferon-based treatment for chronic hepatitis C virus (HCV) infection has been strongly linked with decreased incidence of hepatocellular carcinoma (HCC). Surprisingly, several recent studies have reported higher rates of HCC in individuals treated with direct-acting antivirals (DAAs). However, making definitive conclusions has been challenging due to the heterogeneous populations and methodologies of these reports. As such, we sought to investigate whether DAA use is associated with increased rates of incident HCC. Methods Using the Electronically Retrieved Cohort of HCV Infected Veterans (ERCHIVES) database, we identified 17,836 patients without a prior diagnosis of HCC and divided them into 3 groups based on treatment: (a) pegylated interferon and ribavirin (IFN) (n = 3,534); (b) DAA-based therapy (n = 5,734); and (c) an untreated control group (n = 8,468). Predictors of HCC were identified using multivariate Cox proportional hazards analysis. HCC-free survival in cirrhotics was assessed by Kaplan–Meier analysis. Results SVR was achieved by 66.6% and 96.2% of the IFN and DAA groups, respectively. In our cohort, the incidence rate of HCC was not different between IFN and DAA groups (7.48/1000 vs. 7.92/1000 patient-years of follow-up; P = 0.72). Moreover, DAA treatment was not associated with an increased risk of HCC (HR 1.16; [95% CI: 0.79, 1.71]) compared to IFN treatment. Other risk factors for HCC included older age, alcohol abuse/dependance history, smoking history, HCV genotype 3 infection, proton-pump inhibitor use, AFP &gt; 20, and cirrhosis. Notably, among cirrhotics who achieve SVR, HCC-free survival was not different between IFN and DAA treated groups, and both groups had significantly improved HCC-free survival compared with untreated patients. Conclusion Among cirrhotic patients with HCV, DAA treatment is associated with a comparable risk of HCC to IFN treatment. Furthermore, the rate of HCC after SVR by any treatment was significantly lower than for those untreated or who failed to achieve SVR. Previously reported increases in HCC associated with DAA treatment appear to be explained by the presence of pre-existing risk factors for HCC. Disclosures R. T. Chung, Gilead: Investigator, Research grant; Abbvie: Investigator, Research grant; Merck: Investigator, Research grant; Janssen: Investigator, Research grant; A. Butt, Merck: Investigator, Grant recipient

Development of Hepatocellular Carcinoma in Patients Aged 75–84 Years With Chronic Hepatitis C Treated With Direct-Acting Antivirals

2020 ◽  
Author(s):  
Eiichi Ogawa ◽  
Hideyuki Nomura ◽  
Makoto Nakamuta ◽  
Norihiro Furusyo ◽  
Eiji Kajiwara ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Chronic Hepatitis C ◽  
Multicenter Cohort Study ◽  
Direct Acting Antiviral ◽  
Significant Difference ◽  
Direct Acting

Abstract Background Direct-acting antiviral (DAA) treatment has revolutionized hepatitis C virus (HCV) care. We aimed to evaluate the risk for the development of hepatocellular carcinoma (HCC) in patients aged 75–84 years with chronic hepatitis C after HCV elimination. Methods This multicenter cohort study included 2405 consecutive patients with chronic hepatitis C without a history of HCC who achieved HCV elimination by DAAs. Patients in whom HCC developed within 1 year of DAA initiation were excluded. Propensity score matching analysis was used to evaluate differences in HCC risk between patients aged 75–84 versus 60–74 years. Results The median observational period was 3.5 years. Among patients aged 75–84 years with a high Fibrosis-4 (FIB-4) index (≥3.25 at baseline), there was no significant difference in the annual incidence of HCCs between groups with an FIB-4 index ≥3.25 (2.75 per 100 person-years [PY]) versus &lt;3.25 (2.16 per 100 PY) at 12 weeks after the end of treatment, unlike the results in those aged 60–74 years (3.61 and 1.51 per 100 PY, respectively) (adjusted hazard ratio, 2.20; P = .04). In 495 pairs matched by propensity score matching, in patients without cirrhosis, the cumulative HCC incidence was significantly higher in the 75–84-year than in the 60–74-year age group (P = .04). Conclusions Older patients aged 75–84 years remained at high risk for the development of HCC, even after HCV elimination and the improvement of the FIB-4 index to &lt;3.25.

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