Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antivirals
Introduction and aim: Chronic hepatitis C is one of the main causes of cirrhosis of the liver. Treatment with direct-acting antivirals (DAAs) improves survival. There is controversy as to whether AADs create an increased risk for the development of hepatocellular carcinoma (HCC). The aim of the pres...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Revista de Gastroenterología de México (English Edition) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255534X22000251 |
| _version_ | 1798018560871628800 |
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| author | I. Santana-Salgado A. Bautista-Santos R. Moreno-Alcántar |
| author_facet | I. Santana-Salgado A. Bautista-Santos R. Moreno-Alcántar |
| author_sort | I. Santana-Salgado |
| collection | DOAJ |
| description | Introduction and aim: Chronic hepatitis C is one of the main causes of cirrhosis of the liver. Treatment with direct-acting antivirals (DAAs) improves survival. There is controversy as to whether AADs create an increased risk for the development of hepatocellular carcinoma (HCC). The aim of the present study was to determine the risk factors for developing HCC in patients with chronic hepatitis C treated with DAAs. Materials and methods: A cohort study was conducted, within the time frame of June 2017 and June 2018, on patients >18 years of age, with chronic hepatitis C, genotypes 1 and 4, with one year of follow-up, to evaluate the presence of HCC. Results: We analyzed 108 patients, 71 (65%) of whom were women. Mean patient age was 56.24 years (±10.6), 1b was the most frequent genotype (63%), and 49% of the patients received treatment with DAAs (ombitasvir/paritaprevir/ritonavir plus dasabuvir). Thirty-four (31%) patients were obese. Fifty-three percent (58) had cirrhosis and 82% (89) had Child-Pugh class A liver function. Sustained virologic response at 12 weeks was 100%. Eight (7%) patients developed HCC and 1b was the most frequently associated genotype (87%). The presence of regenerative nodules >10 mm (P < .05), esophageal varices (P < .05), cirrhosis of the liver (P < .05), Child-Pugh B-C (P < .05), and alpha-fetoprotein >20 IU/mL (P = 0.20) one year after treatment were associated with the development of HCC. Conclusions: The risk factors for developing HCC were the presence of cirrhosis of the liver, Child-Pugh class B liver function, esophageal and/or gastric varices, and genotype 1b. Resumen: Introducción y objetivo: La hepatitis C crónica es de las principales causas de cirrosis hepática. El tratamiento con antivirales de acción directa (AAD) mejora la supervivencia. Existe controversia si los AAD generan un incremento del riesgo para desarrollar carcinoma hepatocelular (CHC). El objetivo del trabajo es determinar los factores de riesgo para desarrollar CHC en pacientes con hepatitis C crónica tratados con AAD. Material y métodos: Estudio de cohorte realizado de junio de 2017 a junio de 2018, incluyó a pacientes >18 años con hepatitis C crónica, genotipo 1 y 4, tratados con AAD, con un año de seguimiento para evaluar la presencia de CHC. Resultados: Analizamos 108 pacientes, 71 mujeres (65%), edad media de 56.24 años (±10.6), el genotipo más frecuente 1b (63%), el 49% recibió tratamiento con (ombitasvir, paritaprevir, ritonavir, dasabuvir). Treinta y cuatro pacientes (31%) tenían obesidad. El 53% tenía cirrosis (58) y el 82% en Child-Pugh A (89). La respuesta viral sostenida a las 12 semanas fue del 100%. Ocho pacientes (7%) desarrollaron CHC y el genotipo más asociado fue 1b (87%). La presencia de nódulos de regeneración >10 mm (p < 0.05), várices esofágicas (p < 0.05), cirrosis hepática (p < 0.05), Child-Pugh B y C (p < 0.05) y alfafetoproteína > 20 UI/mL (p 0.20) un año postratamiento, se asociaron al desarrollo de CHC. Conclusiones: Los factores de riesgo para desarrollar CHC fue la presencia de cirrosis hepática, clase funcional Child-Pugh B, varices esofágicas y/o gástricas y genotipo 1b. |
| first_indexed | 2024-04-11T16:24:56Z |
| format | Article |
| id | doaj.art-ddc212cab6c640edbd3ae28af5ed3153 |
| institution | Directory Open Access Journal |
| issn | 2255-534X |
| language | English |
| last_indexed | 2024-04-11T16:24:56Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista de Gastroenterología de México (English Edition) |
| spelling | doaj.art-ddc212cab6c640edbd3ae28af5ed31532022-12-22T04:14:12ZengElsevierRevista de Gastroenterología de México (English Edition)2255-534X2022-10-01874455461Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antiviralsI. Santana-Salgado0A. Bautista-Santos1R. Moreno-Alcántar2Servicio de Gastroenterología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoCorresponding author at: M. en C.S. Aleida Bautista Santos, Av. Cuauhtémoc 330, Colonia Doctores, Delegación Cuauhtémoc, CP. 06720, Mexico. Tel.: 0155 5627 6900, Ext.: 21565/21566.; Servicio de Gastroenterología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoServicio de Gastroenterología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, MexicoIntroduction and aim: Chronic hepatitis C is one of the main causes of cirrhosis of the liver. Treatment with direct-acting antivirals (DAAs) improves survival. There is controversy as to whether AADs create an increased risk for the development of hepatocellular carcinoma (HCC). The aim of the present study was to determine the risk factors for developing HCC in patients with chronic hepatitis C treated with DAAs. Materials and methods: A cohort study was conducted, within the time frame of June 2017 and June 2018, on patients >18 years of age, with chronic hepatitis C, genotypes 1 and 4, with one year of follow-up, to evaluate the presence of HCC. Results: We analyzed 108 patients, 71 (65%) of whom were women. Mean patient age was 56.24 years (±10.6), 1b was the most frequent genotype (63%), and 49% of the patients received treatment with DAAs (ombitasvir/paritaprevir/ritonavir plus dasabuvir). Thirty-four (31%) patients were obese. Fifty-three percent (58) had cirrhosis and 82% (89) had Child-Pugh class A liver function. Sustained virologic response at 12 weeks was 100%. Eight (7%) patients developed HCC and 1b was the most frequently associated genotype (87%). The presence of regenerative nodules >10 mm (P < .05), esophageal varices (P < .05), cirrhosis of the liver (P < .05), Child-Pugh B-C (P < .05), and alpha-fetoprotein >20 IU/mL (P = 0.20) one year after treatment were associated with the development of HCC. Conclusions: The risk factors for developing HCC were the presence of cirrhosis of the liver, Child-Pugh class B liver function, esophageal and/or gastric varices, and genotype 1b. Resumen: Introducción y objetivo: La hepatitis C crónica es de las principales causas de cirrosis hepática. El tratamiento con antivirales de acción directa (AAD) mejora la supervivencia. Existe controversia si los AAD generan un incremento del riesgo para desarrollar carcinoma hepatocelular (CHC). El objetivo del trabajo es determinar los factores de riesgo para desarrollar CHC en pacientes con hepatitis C crónica tratados con AAD. Material y métodos: Estudio de cohorte realizado de junio de 2017 a junio de 2018, incluyó a pacientes >18 años con hepatitis C crónica, genotipo 1 y 4, tratados con AAD, con un año de seguimiento para evaluar la presencia de CHC. Resultados: Analizamos 108 pacientes, 71 mujeres (65%), edad media de 56.24 años (±10.6), el genotipo más frecuente 1b (63%), el 49% recibió tratamiento con (ombitasvir, paritaprevir, ritonavir, dasabuvir). Treinta y cuatro pacientes (31%) tenían obesidad. El 53% tenía cirrosis (58) y el 82% en Child-Pugh A (89). La respuesta viral sostenida a las 12 semanas fue del 100%. Ocho pacientes (7%) desarrollaron CHC y el genotipo más asociado fue 1b (87%). La presencia de nódulos de regeneración >10 mm (p < 0.05), várices esofágicas (p < 0.05), cirrosis hepática (p < 0.05), Child-Pugh B y C (p < 0.05) y alfafetoproteína > 20 UI/mL (p 0.20) un año postratamiento, se asociaron al desarrollo de CHC. Conclusiones: Los factores de riesgo para desarrollar CHC fue la presencia de cirrosis hepática, clase funcional Child-Pugh B, varices esofágicas y/o gástricas y genotipo 1b.http://www.sciencedirect.com/science/article/pii/S2255534X22000251Hepatitis C crónicaAntivirales de acción directaCarcinoma hepatocelular |
| spellingShingle | I. Santana-Salgado A. Bautista-Santos R. Moreno-Alcántar Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antivirals Revista de Gastroenterología de México (English Edition) Hepatitis C crónica Antivirales de acción directa Carcinoma hepatocelular |
| title | Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antivirals |
| title_full | Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antivirals |
| title_fullStr | Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antivirals |
| title_full_unstemmed | Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antivirals |
| title_short | Risk factors for developing hepatocellular carcinoma in patients treated with direct-acting antivirals |
| title_sort | risk factors for developing hepatocellular carcinoma in patients treated with direct acting antivirals |
| topic | Hepatitis C crónica Antivirales de acción directa Carcinoma hepatocelular |
| url | http://www.sciencedirect.com/science/article/pii/S2255534X22000251 |
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