Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study
Background and aim: The incidence of hepatocellular carcinoma (HCC) decreases significantly in chronic hepatitis C (CHC) patients with sustained virologic response (SVR) after pegylated-interferon plus ribavirin (PR) or direct-acting antiviral (DAAs) therapy. We follow-up a single cohort of CHC pati...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Metabolism Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589936821000141 |
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| author | Dong Ji Guo-feng Chen Xiao-xia Niu Mingjie Zhang Cheng Wang Qing Shao Vanessa Wu Yudong Wang Gregory Cheng Selwyn J. Hurwitz Raymond F. Schinazi George Lau |
| author_facet | Dong Ji Guo-feng Chen Xiao-xia Niu Mingjie Zhang Cheng Wang Qing Shao Vanessa Wu Yudong Wang Gregory Cheng Selwyn J. Hurwitz Raymond F. Schinazi George Lau |
| author_sort | Dong Ji |
| collection | DOAJ |
| description | Background and aim: The incidence of hepatocellular carcinoma (HCC) decreases significantly in chronic hepatitis C (CHC) patients with sustained virologic response (SVR) after pegylated-interferon plus ribavirin (PR) or direct-acting antiviral (DAAs) therapy. We follow-up a single cohort of CHC patients to identify risk factors associated with HCC development post-SVR. Method: CHC patients with SVR in Beijing/Hong Kong were followed up at 12–24 weekly intervals with surveillance for HCC by ultrasonography and alpha-fetoprotein (AFP). Multivariate Cox proportional hazards regression analysis was used to explore factors associated with HCC occurrence. Results: Between October 2015 and May 2017, SVR was observed in 519 and 817 CHC patients after DAAs and PR therapy respectively. After a median post -SVR follow-up of 48 months, HCC developed in 54 (4.4%) SVR subjects. By adjusted Cox analysis, older age (≥55 years) [HR 2.4, 95% CI (1.3–4.3)], non-alcoholic fatty liver diseases [HR 2.4, 95%CI (1.3–4.2), higher AFP level (≥20 ng/ml) [HR 3.4, 95%CI (2.0–5.8)], higher liver stiffness measurement (≥14.6 kPa) [HR 4.2, 95%CI (2.3–7.6)], diabetes mellitus [HR 4.2, 95%CI (2.4–7.4)] at pre-treatment were associated with HCC occurrence. HCC patients in the DAAs induced SVR group had a higher prevalence of NAFLD as compared with those in the PR induced SVR group, 62% (18/29) vs 28% (7/25), p = 0.026. A nomogram formulated with the above six independent variables had a Concordance-Index of 0.835 (95% CI 0.783–0.866). Conclusion: Underlying NAFLD is associated with increased incidence of HCC in chronic HCV patients post-SVR, particularly in those treated with DAA. |
| first_indexed | 2024-12-21T02:12:12Z |
| format | Article |
| id | doaj.art-9a948444dbf84dc0a7e00a6d6cdedda0 |
| institution | Directory Open Access Journal |
| issn | 2589-9368 |
| language | English |
| last_indexed | 2024-12-21T02:12:12Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Metabolism Open |
| spelling | doaj.art-9a948444dbf84dc0a7e00a6d6cdedda02022-12-21T19:19:20ZengElsevierMetabolism Open2589-93682021-06-0110100090Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up studyDong Ji0Guo-feng Chen1Xiao-xia Niu2Mingjie Zhang3Cheng Wang4Qing Shao5Vanessa Wu6Yudong Wang7Gregory Cheng8Selwyn J. Hurwitz9Raymond F. Schinazi10George Lau11Department of Liver Diseases, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China; Fifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, ChinaDepartment of Liver Diseases, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China; Fifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, ChinaDepartment of Liver Diseases, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China; Fifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, ChinaFaculty of Health Science, Macau University, Taipa, MacauFifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, China; Humanity and Health Clinical Trial Center, Humanity & Health Medical Group, Hong Kong, ChinaDepartment of Liver Diseases, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China; Fifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, ChinaFifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, China; Humanity and Health Clinical Trial Center, Humanity & Health Medical Group, Hong Kong, ChinaFifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, China; Humanity and Health Clinical Trial Center, Humanity & Health Medical Group, Hong Kong, ChinaFaculty of Health Science, Macau University, Taipa, Macau; Humanity and Health Clinical Trial Center, Humanity & Health Medical Group, Hong Kong, ChinaCenter for AIDS Research, Laboratory of Biochemical Pharmacology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, 30322, USACenter for AIDS Research, Laboratory of Biochemical Pharmacology, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, 30322, USADepartment of Liver Diseases, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China; Fifth Medical Center of Chinese PLA General Hospital-Hong Kong Humanity and Health Hepatitis C Diagnosis and Treatment Centre, Beijing, 100039, China; Humanity and Health Clinical Trial Center, Humanity & Health Medical Group, Hong Kong, China; Corresponding author. Humanity and Health Clinical Trial Center, Humanity & Health Medical Group, Hong Kong, China.Background and aim: The incidence of hepatocellular carcinoma (HCC) decreases significantly in chronic hepatitis C (CHC) patients with sustained virologic response (SVR) after pegylated-interferon plus ribavirin (PR) or direct-acting antiviral (DAAs) therapy. We follow-up a single cohort of CHC patients to identify risk factors associated with HCC development post-SVR. Method: CHC patients with SVR in Beijing/Hong Kong were followed up at 12–24 weekly intervals with surveillance for HCC by ultrasonography and alpha-fetoprotein (AFP). Multivariate Cox proportional hazards regression analysis was used to explore factors associated with HCC occurrence. Results: Between October 2015 and May 2017, SVR was observed in 519 and 817 CHC patients after DAAs and PR therapy respectively. After a median post -SVR follow-up of 48 months, HCC developed in 54 (4.4%) SVR subjects. By adjusted Cox analysis, older age (≥55 years) [HR 2.4, 95% CI (1.3–4.3)], non-alcoholic fatty liver diseases [HR 2.4, 95%CI (1.3–4.2), higher AFP level (≥20 ng/ml) [HR 3.4, 95%CI (2.0–5.8)], higher liver stiffness measurement (≥14.6 kPa) [HR 4.2, 95%CI (2.3–7.6)], diabetes mellitus [HR 4.2, 95%CI (2.4–7.4)] at pre-treatment were associated with HCC occurrence. HCC patients in the DAAs induced SVR group had a higher prevalence of NAFLD as compared with those in the PR induced SVR group, 62% (18/29) vs 28% (7/25), p = 0.026. A nomogram formulated with the above six independent variables had a Concordance-Index of 0.835 (95% CI 0.783–0.866). Conclusion: Underlying NAFLD is associated with increased incidence of HCC in chronic HCV patients post-SVR, particularly in those treated with DAA.http://www.sciencedirect.com/science/article/pii/S2589936821000141Chronic hepatitis CSustained virologic responseNAFLDHCC |
| spellingShingle | Dong Ji Guo-feng Chen Xiao-xia Niu Mingjie Zhang Cheng Wang Qing Shao Vanessa Wu Yudong Wang Gregory Cheng Selwyn J. Hurwitz Raymond F. Schinazi George Lau Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study Metabolism Open Chronic hepatitis C Sustained virologic response NAFLD HCC |
| title | Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study |
| title_full | Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study |
| title_fullStr | Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study |
| title_full_unstemmed | Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study |
| title_short | Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study |
| title_sort | non alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis c patients a prospective four years follow up study |
| topic | Chronic hepatitis C Sustained virologic response NAFLD HCC |
| url | http://www.sciencedirect.com/science/article/pii/S2589936821000141 |
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