Details

Autor(en) / Beteiligte

• Calvaruso, Vincenza
• Cabibbo, Giuseppe
• Cacciola, Irene
• Petta, Salvatore
• Madonia, Salvatore
• Bellia, Alessandro
• Tinè, Fabio
• Distefano, Marco
• Licata, Anna
• Giannitrapani, Lydia
• Prestileo, Tullio
• Mazzola, Giovanni
• Di Rosolini, Maria Antonietta
• Larocca, Licia
• Bertino, Gaetano
• Digiacomo, Antonio
• Benanti, Francesco
• Guarneri, Luigi
• Averna, Alfonso
• Iacobello, Carmelo
• Magro, Antonio
• Scalisi, Ignazio
• Cartabellotta, Fabio
• Savalli, Francesca
• Barbara, Marco
• Davì, Antonio
• Russello, Maurizio
• Scifo, Gaetano
• Squadrito, Giovanni
• Cammà, Calogero
• Raimondo, Giovanni
• Craxì, Antonio
• Di Marco, Vito
• Craxì, A.
• Di Marco, V.
• Cammà, C.
• Calvaruso, V.
• Petta, S.
• Cabbibbo, G.
• Colletti, P.
• Mazzola, G.
• Cascio, A.
• Montalto, G.
• Licata, A.
• Giannitrapani, L.
• Prestileo, T.
• Di Lorenzo, F.
• Sanfilippo, A.
• Ficalora, A.
• Madonia, S.
• Tinè, F.
• Malizia, G.
• Latteri, F.
• Maida, M.
• Cartabellotta, F.
• Vassallo, R.
• Cacciola, I.
• Caccamo, G.
• Maimone, S.
• Saitta, C.
• Squadrito, G.
• Raimondo, G.
• Mondello, L.
• Smedile, A.
• D’Andrea, S.
• Bertino, G.
• Ardiri, A.L.
• Frazzetto, E.
• Rigano, G.
• Montineri, A.
• Larocca, L.N.
• Cacopardo, B.
• Benanti, F.
• Russello, M.
• Benigno, R.
• Bellia, A.
• Iacobello, C.
• Davì, A.
• Di Rosolini, M.A.
• Digiacomo, A.
• Fuduli, G.
• Scifo, G.
• Distefano, M.
• Portelli, V.
• Savalli, F.
• Scalici, I.
• Gioia, G.
• Magro, A.
• Alaimo, G.
• Alinovi, M.R.
• Salvo, A.
• Averna, A.
• Lomonaco, F.
• Guarneri, L.
• Maffeo, F.
• Falzone, E.
• Pulvirenti, F.

Titel

Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents

Ist Teil von

• Gastroenterology (New York, N.Y. 1943), 2018-08, Vol.155 (2), p.411-421.e4

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Studies have produced conflicting results of the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis C virus–associated cirrhosis treated with direct-acting antivirals (DAAs). Data from clinics are needed to accurately assess the occurrence rate of HCC in patients with cirrhosis in the real world. We collected data from a large prospective study of 2,249 consecutive patients (mean age = 65.4 years, 56.9% male) with hepatitis C virus–associated cirrhosis (90.5% with Child-Pugh class A and 9.5% with Child-Pugh class B) treated with DAAs from March 2015 through July 2016 at 22 academic and community liver centers in Sicily, Italy. HCC occurrence was evaluated by Kaplan-Meier curves. Cox regression analysis was used to identify variables associated with HCC development. A sustained virologic response (SVR) was achieved by 2,140 patients (total = 95.2%; 95.9% with Child Pugh class A and 88.3% with Child Pugh class B; P < .001). Seventy-eight patients (3.5%) developed HCC during a mean follow-up of 14 months (range = 6–24 months). At 1 year after exposure to DAAs, HCC developed in 2.1% of patients with Child-Pugh class A with an SVR and 6.6% of patients with no SVR and in 7.8% of patients with Child-Pugh class B with an SVR and 12.4% of patients with no SVR (P < .001 by log-rank test). Albumin level below 3.5 g/dL (hazard ratio = 1.77, 95% confidence interval = 1.12–2.82, P = .015), platelet count below 120 × 109/L (hazard ratio = 3.89, 95% confidence interval = 2.11–7.15, P < .001), and absence of an SVR (hazard ratio = 3.40, 95% confidence interval = 1.89–6.12, P < .001) were independently associated increased risk for HCC. The mean interval from exposure to DAAs to an HCC diagnosis was 9.8 months (range = 2–22 months) and did not differ significantly between patients with (n = 64, 9.2 months) and without (n = 14, 12.0 months) an SVR (P = .11). A larger proportion of patients with an SVR had a single HCC lesion (78% vs 50% without an SVR; P = .009) or an HCC lesion smaller than 3 cm (58% vs 28% without an SVR; P = .07). In an analysis of data from a large prospective study of patients with hepatitis C virus–associated compensated or decompensated cirrhosis, we found that the SVR to DAA treatment decreased the incidence of HCC over a mean follow-up of 14 months.