Liver Fibrosis and Body Mass Index Predict Hepatocarcinogenesis following Eradication of Hepatitis C Virus RNA by Direct-Acting Antivirals.

Abstract

BACKGROUND AND AIMS:

Predictive factors for hepatocarcinogenesis following eradication of hepatitis C virus (HCV) RNA by antiviral therapy with direct-acting antivirals are unknown. Especially the impact of treatment with or without interferon on hepatocarcinogenesis is not clear.

METHODS:

A total of 958 patients with HCV genotype 1-related chronic liver disease and a sustained virological response defined as negative HCV RNA 24 weeks after cessation of antiviral therapy with direct-acting antivirals (triple therapy of NS3/4A protease inhibitor/peginterferon/ribavirin or all-oral combination therapy with NS3/4A protease inhibitor plus NS5A inhibitor) were included in a retrospective study. None of the patients had hepatocellular carcinoma before and during antiviral therapy.

RESULTS:

In all, 14 patients developed hepatocellular carcinoma during follow-up, and the development rate per 1,000 person-years was 7.35. The cumulative hepatocarcinogenesis rates were 4.2 and 4.2% at the end of 5 and 7 years, respectively. Multivariate analysis identified fibrosis 4 (FIB4) index (≥2.7) and body mass index (≥23.0) as determinants of hepatocarcinogenesis, but they did not identify the treatment regimen. In patients with a FIB4 index ≥2.7, the hepatocarcinogenesis rates with the interferon regimen were not different from those for the regimen without interferon, regardless of gender.

CONCLUSION:

Liver fibrosis and body mass index, but not treatment regimen, are important predictors of hepatocarcinogenesis following eradication of HCV RNA by direct-acting antivirals.

• Authors: Norio Akuta, Masahiro Kobayashi, Fumitaka Suzuki, Hitomi Sezaki, Shunichiro Fujiyama, Yusuke Kawamura, Tetsuya Hosaka, Mariko Kobayashi, Satoshi Saitoh, Yoshiyuki Suzuki, Yasuji Arase, Kenji Ikeda, Hiromitsu Kumada
• Journal: Oncology (Oncology) Vol. 91 Issue 6 Pg. 341-347 ( 2016) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 27694754 (Publication Type: Journal Article)
• Copyright: © 2016 S. Karger AG, Basel.

Chemical References

• Antiviral Agents
• Carbamates
• Imidazoles
• Interferon Type I
• Isoquinolines
• Oligopeptides
• Pyrrolidines
• RNA, Viral
• Sulfonamides
• Ribavirin
• telaprevir
• Valine
• daclatasvir
• asunaprevir

Topics

• Adult
• Aged
• Aged, 80 and over
• Antiviral Agents (therapeutic use)
• Body Mass Index
• Carbamates
• Carcinoma, Hepatocellular (epidemiology, virology)
• Cell Transformation, Neoplastic
• Drug Therapy, Combination
• Female
• Genotype
• Hepacivirus (genetics)
• Hepatitis C, Chronic (drug therapy)
• Humans
• Imidazoles (therapeutic use)
• Interferon Type I (therapeutic use)
• Isoquinolines (therapeutic use)
• Liver Cirrhosis (pathology, virology)
• Liver Neoplasms (epidemiology, virology)
• Male
• Middle Aged
• Oligopeptides (therapeutic use)
• Pyrrolidines
• RNA, Viral (blood)
• Ribavirin (therapeutic use)
• Risk Factors
• Sulfonamides (therapeutic use)
• Sustained Virologic Response
• Valine (analogs & derivatives)
• Young Adult