Development of hepatocellular carcinoma in patients with chronic hepatitis C who had a sustained virological response to interferon therapy: a multicenter, retrospective cohort study of 1124 patients

Abstract

SVR patients with CH-C who are elderly, male, or have an advanced histologic stage are at a high risk for the development of HCC after IFN therapy. We recommend that SVR patients should be observed carefully for more than 10 years after the completion of IFN therapy, even if they only have early fibrosis.

TGF-β signal shifting between tumor suppression and fibro-carcinogenesis in human chronic liver diseases

“…Similarly, pSmad2L/ C-mediated signaling constitutively induces ECM deposition in pre-neoplastic hepatocytes and HCC by up-regulating PAI-1 transcription [16]. No potentially preventive effects of anti-HCV therapies are able to reduce liver fibrosis and development of HCC once HCV-related cirrhosis is established [10,11]. Consistent with this observation, hepatocytes maintaining high carcinogenic pSmad3L and fibrogenic pSmad2L/C signaling cannot return to tumor-suppressive pSmad3C signaling, even after HCV clearance (Fig.…”

“…In chronic hepatitis, HCC occurrence clearly depends on continued presence of hepatitis viruses and chronic inflammation. In contrast, patients with cirrhosis have relatively low but real risks of HCC occurrence and hepatic decompensation despite SVR [10,11].…”

10.5937/mckg48-5925 = Therapy of chronic HCV infection: Association between virological response and predictive factors

“…Bolesnici koji su inficirani HCV genotipom 1 i postignu rani virusološki odgovor (HCV rnK pozitivna u 4. nedelji, ali negativna 12. nedelji terapije) leče se 48 nedelja. Odsustvo HCV rnK nakon 48 nedelja lečenja definiše se kao odgovor na kraju terapije (End Tretatmen response -ETr) (28)(29)(30)(31)(32)(33)(34)(35). Trajni virusološki odgovor (Sustained Viral responseSVr) definiše se odsutnošću virusa u krvi (HCV rnK <50 iu/ml), šest meseci nakon završetka terapije.…”

Viral hepatitis and hepatocellular carcinoma: etiology and management

“…All the patients in the study had bridging fibrosis or cirrhosis and the median follow up was 2.1 years. An analysis of 1,124 HCV patients reported that 3.5% of patients with virologic cure developed HCC after a median follow up of 5.8 years (75). The patients with virologic cure who developed HCC were more likely to be male, older, and have more advanced fibrosis compared to patients with a SVR who did not develop HCC.…”

“…Studies demonstrate that the risk of HCC in individuals who achieve virologic cure is reduced compared to nonresponders (74)(75)(76)(77)(78). In a multicenter retrospective study of 479 HCV patients treated with IFN or PEG-IFN with or without ribavirin, 142 (29.6%) subjects had a sustained response (74).…”