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HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort
Background Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients. Methods To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did...
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| Published in: | Hepatology international 2020-12, Vol.14 (6), p.1023-1033 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| creator | Tanaka, Yasuhito Ogawa, Eiichi Huang, Chung-Feng Toyoda, Hidenori Jun, Dae Won Tseng, Cheng-Hao Hsu, Yao-Chun Enomoto, Masaru Takahashi, Hirokazu Furusyo, Norihiro Yeh, Ming-Lun Iio, Etsuko Yasuda, Satoshi Lam, Carla Pui-Mei Lee, Dong Hyun Haga, Hiroaki Yoon, Eileen L. Ahn, Sang Bong Wong, Grace Nakamuta, Makoto Nomura, Hideyuki Tsai, Pei-Chien Jung, Jang Han Song, Do Seon Dang, Hansen Maeda, Mayumi Henry, Linda Cheung, Ramsey Yuen, Man-Fung Ueno, Yoshiyuki Eguchi, Yuichiro Tamori, Akihiro Yu, Ming-Lung Hayashi, Jun Nguyen, Mindie H. |
| description | Background
Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients.
Methods
To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups.
Results
In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94,
p
|
| doi_str_mv | 10.1007/s12072-020-10105-2 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2467613787</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2467613787</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-29c09080af5a1a5e5aaa884698b136d4b1b6dc38f71e9119fcab4cd89afbe0f33</originalsourceid><addsrcrecordid>eNp9kMtOwzAQRS0EoqXwAyyQJTZsAh47thN2VSgPUQmJ19ZyErtNaZPiSYX4e1LKQ2LBakaaM3dGh5BDYKfAmD5D4EzziHEWAQMmI75F-pAKFTEZw_ZPL0SP7CHOGJNSgdolPSG41iqRfXJ7nWU0VPhClw220cPzPX2r2im9GA6RVjUdWWzpECtb4zn1VV1W9QSpD82CtlNH70fDcZTRopk2od0nO97O0R181QF5uhw9ZtfR-O7qJuvAQmjZRjwtWMoSZr20YKWT1tokiVWa5CBUGeeQq7IQidfgUoDUFzaPizJJrc8d80IMyMkmdxma15XD1iwqLNx8bmvXrNDwWGkFQie6Q4__oLNmFeruu47SmqtYwJriG6oIDWJw3ixDtbDh3QAza9Vmo9p0qs2nasO7paOv6FW-cOXPyrfbDhAbALtRPXHh9_Y_sR9OvIYR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2477264317</pqid></control><display><type>article</type><title>HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort</title><source>Springer Nature</source><creator>Tanaka, Yasuhito ; Ogawa, Eiichi ; Huang, Chung-Feng ; Toyoda, Hidenori ; Jun, Dae Won ; Tseng, Cheng-Hao ; Hsu, Yao-Chun ; Enomoto, Masaru ; Takahashi, Hirokazu ; Furusyo, Norihiro ; Yeh, Ming-Lun ; Iio, Etsuko ; Yasuda, Satoshi ; Lam, Carla Pui-Mei ; Lee, Dong Hyun ; Haga, Hiroaki ; Yoon, Eileen L. ; Ahn, Sang Bong ; Wong, Grace ; Nakamuta, Makoto ; Nomura, Hideyuki ; Tsai, Pei-Chien ; Jung, Jang Han ; Song, Do Seon ; Dang, Hansen ; Maeda, Mayumi ; Henry, Linda ; Cheung, Ramsey ; Yuen, Man-Fung ; Ueno, Yoshiyuki ; Eguchi, Yuichiro ; Tamori, Akihiro ; Yu, Ming-Lung ; Hayashi, Jun ; Nguyen, Mindie H.</creator><creatorcontrib>Tanaka, Yasuhito ; Ogawa, Eiichi ; Huang, Chung-Feng ; Toyoda, Hidenori ; Jun, Dae Won ; Tseng, Cheng-Hao ; Hsu, Yao-Chun ; Enomoto, Masaru ; Takahashi, Hirokazu ; Furusyo, Norihiro ; Yeh, Ming-Lun ; Iio, Etsuko ; Yasuda, Satoshi ; Lam, Carla Pui-Mei ; Lee, Dong Hyun ; Haga, Hiroaki ; Yoon, Eileen L. ; Ahn, Sang Bong ; Wong, Grace ; Nakamuta, Makoto ; Nomura, Hideyuki ; Tsai, Pei-Chien ; Jung, Jang Han ; Song, Do Seon ; Dang, Hansen ; Maeda, Mayumi ; Henry, Linda ; Cheung, Ramsey ; Yuen, Man-Fung ; Ueno, Yoshiyuki ; Eguchi, Yuichiro ; Tamori, Akihiro ; Yu, Ming-Lung ; Hayashi, Jun ; Nguyen, Mindie H. ; REAL-C Investigators ; For the REAL-C Investigators</creatorcontrib><description>Background
Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients.
Methods
To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups.
Results
In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94,
p
< 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41,
p
= 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5,
p
< 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6,
p
= 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26,
p
= 0.005).
Conclusions
Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.</description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-020-10105-2</identifier><identifier>PMID: 33277685</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Albumins ; Asian people ; Bilirubin ; Cirrhosis ; Colorectal Surgery ; Consortia ; Hepatology ; Liver cancer ; Liver cirrhosis ; Medicine ; Medicine & Public Health ; Original Article ; Risk analysis ; Risk factors ; Subgroups ; Surgery</subject><ispartof>Hepatology international, 2020-12, Vol.14 (6), p.1023-1033</ispartof><rights>Asian Pacific Association for the Study of the Liver 2020</rights><rights>Asian Pacific Association for the Study of the Liver 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-29c09080af5a1a5e5aaa884698b136d4b1b6dc38f71e9119fcab4cd89afbe0f33</citedby><cites>FETCH-LOGICAL-c375t-29c09080af5a1a5e5aaa884698b136d4b1b6dc38f71e9119fcab4cd89afbe0f33</cites><orcidid>0000-0002-6275-4989</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33277685$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tanaka, Yasuhito</creatorcontrib><creatorcontrib>Ogawa, Eiichi</creatorcontrib><creatorcontrib>Huang, Chung-Feng</creatorcontrib><creatorcontrib>Toyoda, Hidenori</creatorcontrib><creatorcontrib>Jun, Dae Won</creatorcontrib><creatorcontrib>Tseng, Cheng-Hao</creatorcontrib><creatorcontrib>Hsu, Yao-Chun</creatorcontrib><creatorcontrib>Enomoto, Masaru</creatorcontrib><creatorcontrib>Takahashi, Hirokazu</creatorcontrib><creatorcontrib>Furusyo, Norihiro</creatorcontrib><creatorcontrib>Yeh, Ming-Lun</creatorcontrib><creatorcontrib>Iio, Etsuko</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Lam, Carla Pui-Mei</creatorcontrib><creatorcontrib>Lee, Dong Hyun</creatorcontrib><creatorcontrib>Haga, Hiroaki</creatorcontrib><creatorcontrib>Yoon, Eileen L.</creatorcontrib><creatorcontrib>Ahn, Sang Bong</creatorcontrib><creatorcontrib>Wong, Grace</creatorcontrib><creatorcontrib>Nakamuta, Makoto</creatorcontrib><creatorcontrib>Nomura, Hideyuki</creatorcontrib><creatorcontrib>Tsai, Pei-Chien</creatorcontrib><creatorcontrib>Jung, Jang Han</creatorcontrib><creatorcontrib>Song, Do Seon</creatorcontrib><creatorcontrib>Dang, Hansen</creatorcontrib><creatorcontrib>Maeda, Mayumi</creatorcontrib><creatorcontrib>Henry, Linda</creatorcontrib><creatorcontrib>Cheung, Ramsey</creatorcontrib><creatorcontrib>Yuen, Man-Fung</creatorcontrib><creatorcontrib>Ueno, Yoshiyuki</creatorcontrib><creatorcontrib>Eguchi, Yuichiro</creatorcontrib><creatorcontrib>Tamori, Akihiro</creatorcontrib><creatorcontrib>Yu, Ming-Lung</creatorcontrib><creatorcontrib>Hayashi, Jun</creatorcontrib><creatorcontrib>Nguyen, Mindie H.</creatorcontrib><creatorcontrib>REAL-C Investigators</creatorcontrib><creatorcontrib>For the REAL-C Investigators</creatorcontrib><title>HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description>Background
Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients.
Methods
To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups.
Results
In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94,
p
< 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41,
p
= 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5,
p
< 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6,
p
= 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26,
p
= 0.005).
Conclusions
Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.</description><subject>Albumins</subject><subject>Asian people</subject><subject>Bilirubin</subject><subject>Cirrhosis</subject><subject>Colorectal Surgery</subject><subject>Consortia</subject><subject>Hepatology</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Subgroups</subject><subject>Surgery</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kMtOwzAQRS0EoqXwAyyQJTZsAh47thN2VSgPUQmJ19ZyErtNaZPiSYX4e1LKQ2LBakaaM3dGh5BDYKfAmD5D4EzziHEWAQMmI75F-pAKFTEZw_ZPL0SP7CHOGJNSgdolPSG41iqRfXJ7nWU0VPhClw220cPzPX2r2im9GA6RVjUdWWzpECtb4zn1VV1W9QSpD82CtlNH70fDcZTRopk2od0nO97O0R181QF5uhw9ZtfR-O7qJuvAQmjZRjwtWMoSZr20YKWT1tokiVWa5CBUGeeQq7IQidfgUoDUFzaPizJJrc8d80IMyMkmdxma15XD1iwqLNx8bmvXrNDwWGkFQie6Q4__oLNmFeruu47SmqtYwJriG6oIDWJw3ixDtbDh3QAza9Vmo9p0qs2nasO7paOv6FW-cOXPyrfbDhAbALtRPXHh9_Y_sR9OvIYR</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Tanaka, Yasuhito</creator><creator>Ogawa, Eiichi</creator><creator>Huang, Chung-Feng</creator><creator>Toyoda, Hidenori</creator><creator>Jun, Dae Won</creator><creator>Tseng, Cheng-Hao</creator><creator>Hsu, Yao-Chun</creator><creator>Enomoto, Masaru</creator><creator>Takahashi, Hirokazu</creator><creator>Furusyo, Norihiro</creator><creator>Yeh, Ming-Lun</creator><creator>Iio, Etsuko</creator><creator>Yasuda, Satoshi</creator><creator>Lam, Carla Pui-Mei</creator><creator>Lee, Dong Hyun</creator><creator>Haga, Hiroaki</creator><creator>Yoon, Eileen L.</creator><creator>Ahn, Sang Bong</creator><creator>Wong, Grace</creator><creator>Nakamuta, Makoto</creator><creator>Nomura, Hideyuki</creator><creator>Tsai, Pei-Chien</creator><creator>Jung, Jang Han</creator><creator>Song, Do Seon</creator><creator>Dang, Hansen</creator><creator>Maeda, Mayumi</creator><creator>Henry, Linda</creator><creator>Cheung, Ramsey</creator><creator>Yuen, Man-Fung</creator><creator>Ueno, Yoshiyuki</creator><creator>Eguchi, Yuichiro</creator><creator>Tamori, Akihiro</creator><creator>Yu, Ming-Lung</creator><creator>Hayashi, Jun</creator><creator>Nguyen, Mindie H.</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6275-4989</orcidid></search><sort><creationdate>20201201</creationdate><title>HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort</title><author>Tanaka, Yasuhito ; Ogawa, Eiichi ; Huang, Chung-Feng ; Toyoda, Hidenori ; Jun, Dae Won ; Tseng, Cheng-Hao ; Hsu, Yao-Chun ; Enomoto, Masaru ; Takahashi, Hirokazu ; Furusyo, Norihiro ; Yeh, Ming-Lun ; Iio, Etsuko ; Yasuda, Satoshi ; Lam, Carla Pui-Mei ; Lee, Dong Hyun ; Haga, Hiroaki ; Yoon, Eileen L. ; Ahn, Sang Bong ; Wong, Grace ; Nakamuta, Makoto ; Nomura, Hideyuki ; Tsai, Pei-Chien ; Jung, Jang Han ; Song, Do Seon ; Dang, Hansen ; Maeda, Mayumi ; Henry, Linda ; Cheung, Ramsey ; Yuen, Man-Fung ; Ueno, Yoshiyuki ; Eguchi, Yuichiro ; Tamori, Akihiro ; Yu, Ming-Lung ; Hayashi, Jun ; Nguyen, Mindie H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-29c09080af5a1a5e5aaa884698b136d4b1b6dc38f71e9119fcab4cd89afbe0f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Albumins</topic><topic>Asian people</topic><topic>Bilirubin</topic><topic>Cirrhosis</topic><topic>Colorectal Surgery</topic><topic>Consortia</topic><topic>Hepatology</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Subgroups</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tanaka, Yasuhito</creatorcontrib><creatorcontrib>Ogawa, Eiichi</creatorcontrib><creatorcontrib>Huang, Chung-Feng</creatorcontrib><creatorcontrib>Toyoda, Hidenori</creatorcontrib><creatorcontrib>Jun, Dae Won</creatorcontrib><creatorcontrib>Tseng, Cheng-Hao</creatorcontrib><creatorcontrib>Hsu, Yao-Chun</creatorcontrib><creatorcontrib>Enomoto, Masaru</creatorcontrib><creatorcontrib>Takahashi, Hirokazu</creatorcontrib><creatorcontrib>Furusyo, Norihiro</creatorcontrib><creatorcontrib>Yeh, Ming-Lun</creatorcontrib><creatorcontrib>Iio, Etsuko</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Lam, Carla Pui-Mei</creatorcontrib><creatorcontrib>Lee, Dong Hyun</creatorcontrib><creatorcontrib>Haga, Hiroaki</creatorcontrib><creatorcontrib>Yoon, Eileen L.</creatorcontrib><creatorcontrib>Ahn, Sang Bong</creatorcontrib><creatorcontrib>Wong, Grace</creatorcontrib><creatorcontrib>Nakamuta, Makoto</creatorcontrib><creatorcontrib>Nomura, Hideyuki</creatorcontrib><creatorcontrib>Tsai, Pei-Chien</creatorcontrib><creatorcontrib>Jung, Jang Han</creatorcontrib><creatorcontrib>Song, Do Seon</creatorcontrib><creatorcontrib>Dang, Hansen</creatorcontrib><creatorcontrib>Maeda, Mayumi</creatorcontrib><creatorcontrib>Henry, Linda</creatorcontrib><creatorcontrib>Cheung, Ramsey</creatorcontrib><creatorcontrib>Yuen, Man-Fung</creatorcontrib><creatorcontrib>Ueno, Yoshiyuki</creatorcontrib><creatorcontrib>Eguchi, Yuichiro</creatorcontrib><creatorcontrib>Tamori, Akihiro</creatorcontrib><creatorcontrib>Yu, Ming-Lung</creatorcontrib><creatorcontrib>Hayashi, Jun</creatorcontrib><creatorcontrib>Nguyen, Mindie H.</creatorcontrib><creatorcontrib>REAL-C Investigators</creatorcontrib><creatorcontrib>For the REAL-C Investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tanaka, Yasuhito</au><au>Ogawa, Eiichi</au><au>Huang, Chung-Feng</au><au>Toyoda, Hidenori</au><au>Jun, Dae Won</au><au>Tseng, Cheng-Hao</au><au>Hsu, Yao-Chun</au><au>Enomoto, Masaru</au><au>Takahashi, Hirokazu</au><au>Furusyo, Norihiro</au><au>Yeh, Ming-Lun</au><au>Iio, Etsuko</au><au>Yasuda, Satoshi</au><au>Lam, Carla Pui-Mei</au><au>Lee, Dong Hyun</au><au>Haga, Hiroaki</au><au>Yoon, Eileen L.</au><au>Ahn, Sang Bong</au><au>Wong, Grace</au><au>Nakamuta, Makoto</au><au>Nomura, Hideyuki</au><au>Tsai, Pei-Chien</au><au>Jung, Jang Han</au><au>Song, Do Seon</au><au>Dang, Hansen</au><au>Maeda, Mayumi</au><au>Henry, Linda</au><au>Cheung, Ramsey</au><au>Yuen, Man-Fung</au><au>Ueno, Yoshiyuki</au><au>Eguchi, Yuichiro</au><au>Tamori, Akihiro</au><au>Yu, Ming-Lung</au><au>Hayashi, Jun</au><au>Nguyen, Mindie H.</au><aucorp>REAL-C Investigators</aucorp><aucorp>For the REAL-C Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><addtitle>Hepatol Int</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>14</volume><issue>6</issue><spage>1023</spage><epage>1033</epage><pages>1023-1033</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract>Background
Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients.
Methods
To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups.
Results
In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94,
p
< 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41,
p
= 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5,
p
< 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6,
p
= 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26,
p
= 0.005).
Conclusions
Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>33277685</pmid><doi>10.1007/s12072-020-10105-2</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6275-4989</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1936-0533 |
| ispartof | Hepatology international, 2020-12, Vol.14 (6), p.1023-1033 |
| issn | 1936-0533 1936-0541 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2467613787 |
| source | Springer Nature |
| subjects | Albumins Asian people Bilirubin Cirrhosis Colorectal Surgery Consortia Hepatology Liver cancer Liver cirrhosis Medicine Medicine & Public Health Original Article Risk analysis Risk factors Subgroups Surgery |
| title | HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort |
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