Development of hepatocellular carcinoma in elderly patients with chronic hepatitis C with or without elevated aspartate and alanine aminotransferase levels

Hepatitis C virus infection is a long-lasting disease, which causes chronic hepatitis, liver cirrhosis and hepatocellular carcinoma, thus leading to liver-related death. Currently, the optimal treatment for chronic hepatitis C infection is the combination of pegylated interferon and ribavirin. The aim of this review is to assess the long-term clinical outcomes of interferons alone or in combination with ribavirin in the management of chronic hepatitis C.

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“…Thus, the authors of the study recommended that the patients should be treated as early as possible [74].…”

Section: Do the Biochemical Hepatic Markers Correlate With The Develomentioning

confidence: 98%

Basic answers to complicated questions for the course of chronic hepatitis C treatment

Örmeci

Erdem

2012

Expert Review of Gastroenterology & Hepatology

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“…They confirmed that high levels of AFP, transaminases and LS are excellent predictors of HCC but underlined the importance of interquartile range (IQR) in LSMs. This led to the hypothesis of “stiffness shadow” that indicated an inhomogeneous shear stress due to the chaotic tumoral growth in the already hard cirrhotic tissue, with relevant diagnostic repercussions[ 81 , 82 ]. The overall prognostic model combining the four variables demonstrated relevant results both in the training and validation phase with a positive relation with tumor size.…”

Section: Direct-acting Antiviral Agents and Liver Cirrhosis Related Eventsmentioning

confidence: 99%

Elastography as a predictor of liver cirrhosis complications after hepatitis C virus eradication in the era of direct-acting antivirals

Cerrito¹,

Ainora²,

Nicoletti³

et al. 2021

WJH

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Chronic inflammation due to hepatitis C virus (HCV) infection leads to liver fibrosis and rearrangement of liver tissue, which is responsible for the development of portal hypertension (PH) and hepatocellular carcinoma (HCC). The advent of direct-acting antiviral drugs has revolutionized the natural history of HCV infection, providing an overall eradication rate of over 90%. Despite a significant decrease after sustained virological response (SVR), the rate of HCC and liver-related complications is not completely eliminated in patients with advanced liver disease. Although the reasons are still unclear, cirrhosis itself has a residual risk for the development of HCC and other PH-related complications. Ultrasound elastography is a recently developed non-invasive technique for the assessment of liver fibrosis. Following the achievement of SVR, liver stiffness (LS) usually decreases, as a consequence of reduced inflammation and, possibly, fibrosis. Recent studies emphasized the application of LS assessment in the management of patients with SVR in order to define the risk for developing the complications of chronic liver disease (functional decompensation, gastrointestinal bleeding, HCC) and to optimize long-term prognostic outcomes in clinical practice.

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“…Elderly have an accelerated tendency towards liver fibrosis, and they do not tolerate treatment of HCV infection as well as younger patients. With this background, Kobayashi and coworkers from Japan studied retrospectively patients with HCV infection detected at the age of 65 years or above with respect to progression [10]. They found that the prognosis was good in patients with normal transaminases, but that progression occurred in those with elevated levels.…”

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confidence: 97%

This month in the Scandinavian Journal of Gastroenterology

Waldum¹

2009

Scandinavian Journal of Gastroenterology

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Development of hepatocellular carcinoma in elderly patients with chronic hepatitis C with or without elevated aspartate and alanine aminotransferase levels

Abstract: In elderly patients with chronic hepatitis C, cirrhosis and HCC develop more frequently in those with elevated transaminase levels than in those without elevated transaminase levels. Therefore, transaminase levels need to be suppressed below Show more

Cited by 6 publications

References 31 publications

Basic answers to complicated questions for the course of chronic hepatitis C treatment

Basic answers to complicated questions for the course of chronic hepatitis C treatment

Elastography as a predictor of liver cirrhosis complications after hepatitis C virus eradication in the era of direct-acting antivirals

This month in the Scandinavian Journal of Gastroenterology

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