Association between steatohepatitis biomarkers and hepatocellular carcinoma after hepatitis C elimination.

Abstract

BACKGROUND:

A strong association between chronic hepatitis C (CHC) and hepatic steatosis has been reported. However, the influence of steatohepatitis on hepatocellular carcinoma (HCC) after hepatitis C virus (HCV) elimination remains unclear.

AIM:

To evaluate the development of HCC after HCV cure using a new steatohepatitis-related biomarker.

METHODS:

This cohort study analysed the prospective database of 290 CHC patients without a history of HCC who achieved HCV elimination by direct-acting antivirals. We calculated the FibroScan-aspartate aminotransferase (FAST) score 12 weeks after the end of treatment (pw12). The risk of HCC was analysed using the multivariable Cox proportional hazard model.

RESULTS:

HCV genotype (GT)1 was most prevalent at 72.4%, followed by GT2 (26.6%). Median follow-up period was 4.2 years (IQR 3.1-4.5). The cumulative HCC incidence for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35 (log-rank test: P < 0.001). The annual HCC incidence rate for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35, in patients with liver stiffness measurement (LSM) ≥10 kPa (adjusted hazard ratio [HR] 4.41, 95% confidence interval [CI] 1.30-15.0, P = 0.018). After adjusting for variables, including age, albumin, alpha-fetoprotein, the patatin-like phospholipase domain-containing the 3 (PNPLA3) rs738409 genotype, and pw12 fibrosis markers with FIB-4, non-alcoholic fatty liver disease fibrosis score, and LSM, FAST score ≥ 0.35 was associated with the development of HCC (adjusted HR 4.42, 95% CI 1.02-19.9, P = 0.043).

CONCLUSIONS:

Steatohepatitis-related biomarkers with the FAST score are helpful for predicting the development of HCC after HCV elimination.

• Authors: Eiichi Ogawa, Koji Takayama, Satoshi Hiramine, Takeo Hayashi, Kazuhiro Toyoda
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 52 Issue 5 Pg. 866-876 (09 2020) ISSN: 1365-2036 [Electronic] England
• PMID: 32697871 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 John Wiley & Sons Ltd.

Chemical References

• AFP protein, human
• Antiviral Agents
• Biomarkers, Tumor
• alpha-Fetoproteins

Topics

• Adult
• Aged
• Antiviral Agents (therapeutic use)
• Biomarkers, Tumor (analysis, blood, genetics)
• Carcinoma, Hepatocellular (diagnosis, genetics, pathology)
• Cell Transformation, Viral
• Cohort Studies
• Disease Progression
• Fatty Liver (blood, diagnosis, genetics)
• Female
• Genotype
• Hepacivirus (drug effects, genetics, physiology)
• Hepatitis C, Chronic (blood, complications, diagnosis, drug therapy)
• Humans
• Liver Neoplasms (diagnosis, genetics, pathology)
• Male
• Middle Aged
• Polymorphism, Single Nucleotide
• Prognosis
• Remission Induction
• Retrospective Studies
• alpha-Fetoproteins (genetics)