Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradication

Abstract Aims Recent advances of direct‐acting antiviral drugs for hepatitis C virus (HCV) have dramatically improved the sustained virologic response (SVR) rate, but hepatocellular carcinoma (HCC) development rarely occurs even in patients who achieve an SVR. Wisteria floribunda agglutinin‐positive...

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Main Authors: Shunsuke Sato, Hironori Tsuzura, Yuji Kita, Yuji Ikeda, Daishi Kabemura, Sho Sato, Nozomi Amano, Noboru Yatagai, Ayato Murata, Yuji Shimada, Takuya Genda
Format: Article
Language:English
Published: Wiley 2021-10-01
Series:JGH Open
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Online Access:https://doi.org/10.1002/jgh3.12655
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author Shunsuke Sato
Hironori Tsuzura
Yuji Kita
Yuji Ikeda
Daishi Kabemura
Sho Sato
Nozomi Amano
Noboru Yatagai
Ayato Murata
Yuji Shimada
Takuya Genda
author_facet Shunsuke Sato
Hironori Tsuzura
Yuji Kita
Yuji Ikeda
Daishi Kabemura
Sho Sato
Nozomi Amano
Noboru Yatagai
Ayato Murata
Yuji Shimada
Takuya Genda
author_sort Shunsuke Sato
collection DOAJ
description Abstract Aims Recent advances of direct‐acting antiviral drugs for hepatitis C virus (HCV) have dramatically improved the sustained virologic response (SVR) rate, but hepatocellular carcinoma (HCC) development rarely occurs even in patients who achieve an SVR. Wisteria floribunda agglutinin‐positive mac‐2‐binding protein (WFA+‐M2BP) was recently developed as a noninvasive biomarker of liver fibrosis. However, the association between the WFA+‐M2BP level and HCC development after the achievement of an SVR is unclear. Methods and Results We examined the association between WFA+‐M2BP and HCC development in 522 HCV patients who achieved an SVR (Interferon [IFN]‐based therapy, n = 228; IFN‐free therapy, n = 294). Multivariate analysis revealed that a high WFA+‐M2BP level at SVR week 24 after treatment (SVR24) (hazard ratio [HR] = 1.215, P = 0.020), low platelet counts (HR = 0.876, P = 0.037), and old age (HR = 1.073, P = 0.012) were independent risk factors for HCC development regardless of the treatment regimen. Receiver operator characteristics curve analysis revealed that a WFA+‐M2BP level at SVR24 of ≥1.62 cut‐off index (COI) was the cut‐off value for the prediction of HCC development (adjusted HR = 12.565, 95% CI 3.501–45.092, P < 0.001). The 3‐ and 5‐year cumulative incidences of HCC were 1% and 1.6% in patients with low WFA+‐M2BP at SVR24 (<1.62 COI), and 4.7% and 12.5% in patients with high WFA+‐M2BP (≥1.62 COI) were, respectively (P < 0.001). Conclusions The assessment of liver fibrosis using the WFA+‐M2BP level at SVR24 is a useful predictor of HCC development after HCV eradication even in the IFN‐free therapy era.
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spelling doaj.art-3c85d0fa3df04e1391f469f4ed4c6b612022-12-21T22:08:00ZengWileyJGH Open2397-90702021-10-015101203120910.1002/jgh3.12655Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradicationShunsuke Sato0Hironori Tsuzura1Yuji Kita2Yuji Ikeda3Daishi Kabemura4Sho Sato5Nozomi Amano6Noboru Yatagai7Ayato Murata8Yuji Shimada9Takuya Genda10Department of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanDepartment of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Shizuoka JapanAbstract Aims Recent advances of direct‐acting antiviral drugs for hepatitis C virus (HCV) have dramatically improved the sustained virologic response (SVR) rate, but hepatocellular carcinoma (HCC) development rarely occurs even in patients who achieve an SVR. Wisteria floribunda agglutinin‐positive mac‐2‐binding protein (WFA+‐M2BP) was recently developed as a noninvasive biomarker of liver fibrosis. However, the association between the WFA+‐M2BP level and HCC development after the achievement of an SVR is unclear. Methods and Results We examined the association between WFA+‐M2BP and HCC development in 522 HCV patients who achieved an SVR (Interferon [IFN]‐based therapy, n = 228; IFN‐free therapy, n = 294). Multivariate analysis revealed that a high WFA+‐M2BP level at SVR week 24 after treatment (SVR24) (hazard ratio [HR] = 1.215, P = 0.020), low platelet counts (HR = 0.876, P = 0.037), and old age (HR = 1.073, P = 0.012) were independent risk factors for HCC development regardless of the treatment regimen. Receiver operator characteristics curve analysis revealed that a WFA+‐M2BP level at SVR24 of ≥1.62 cut‐off index (COI) was the cut‐off value for the prediction of HCC development (adjusted HR = 12.565, 95% CI 3.501–45.092, P < 0.001). The 3‐ and 5‐year cumulative incidences of HCC were 1% and 1.6% in patients with low WFA+‐M2BP at SVR24 (<1.62 COI), and 4.7% and 12.5% in patients with high WFA+‐M2BP (≥1.62 COI) were, respectively (P < 0.001). Conclusions The assessment of liver fibrosis using the WFA+‐M2BP level at SVR24 is a useful predictor of HCC development after HCV eradication even in the IFN‐free therapy era.https://doi.org/10.1002/jgh3.12655direct‐acting antiviral drughepatitis C virushepatocellular carcinomainterferon‐based therapyinterferon‐free therapysustained virological response
spellingShingle Shunsuke Sato
Hironori Tsuzura
Yuji Kita
Yuji Ikeda
Daishi Kabemura
Sho Sato
Nozomi Amano
Noboru Yatagai
Ayato Murata
Yuji Shimada
Takuya Genda
Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradication
JGH Open
direct‐acting antiviral drug
hepatitis C virus
hepatocellular carcinoma
interferon‐based therapy
interferon‐free therapy
sustained virological response
title Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradication
title_full Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradication
title_fullStr Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradication
title_full_unstemmed Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradication
title_short Post‐treatment serum Wisteria floribunda agglutinin‐positive mac‐2‐binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis C virus eradication
title_sort post treatment serum wisteria floribunda agglutinin positive mac 2 binding protein level is a useful predictor of hepatocellular carcinoma development after hepatitis c virus eradication
topic direct‐acting antiviral drug
hepatitis C virus
hepatocellular carcinoma
interferon‐based therapy
interferon‐free therapy
sustained virological response
url https://doi.org/10.1002/jgh3.12655
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