Non-invasive prediction of liver-related events in patients with HCV-associated compensated advanced chronic liver disease after oral antivirals

Pons, Mónica; Rodríguez‐Tajes, Sergio; Esteban, Juan Ignacio; Mariñó, Zoe; Vargas, Vı́ctor; Lens, Sabela; Buti, Marı́a; Augustín, Salvador; Forns, Xavier; Mínguez, Beatriz; Genescà, Joan

doi:10.1016/j.jhep.2019.10.005

Cited by 144 publications

(159 citation statements)

References 29 publications

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“…We chose to use the PSM FUZZY extension command in Python to balance the SOF-based and SOF-free groups. Variables used in the PSM model included sex, age, serum albumin, ALT, platelet count, AFP, eGFR, cirrhosis, and treatment experience, all of which are clinically important variables for predicting the development of HCC according to recent reports [4][5][6][7][8][11][12][13]16,17]. Caliper matching of the propensity scores was done, and pairs were matched to within a range of 0.2 standard deviations of the logit of the propensity scores [35].…”

Section: Discussionmentioning

confidence: 99%

“…However, the development of HCC has not been well-controlled, even after HCV cure, especially for those with cirrhosis or in old age [4][5][6][7][8]11]. Some fibrosis-related biomarkers, such as FIB-4 index, aspartate aminotransferase to platelet ratio index, liver stiffness measurement, and α-fetoprotein (AFP) level, have been recognized as useful predictors for the development of HCC [4,5,[11][12][13]. The underlying mechanisms of HCV-induced hepatocarcinogenesis have not been fully elucidated, and no clear evidence supports a tumorigenic role of DAAs.…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Hepatocellular Carcinoma after Treatment with Sofosbuvir-Based or Sofosbuvir-Free Regimens in Patients with Chronic Hepatitis C

Ogawa

Nomura

Nakamuta

et al. 2020

Cancers

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Advanced fibrosis/cirrhosis and related biomarkers have been recognized as useful predictors of the development of hepatocellular carcinoma (HCC) by patients with chronic hepatitis C (CHC) following hepatitis C virus (HCV) cure by direct-acting antivirals (DAAs). However, it remains unclear if DAAs themselves have an influence on or facilitate the development of HCC. This multicenter cohort study included CHC patients without a history of HCC who achieved HCV elimination by DAAs. Cohorts of 835 patients treated with a sofosbuvir (SOF)-based regimen and 835 treated with a SOF-free regimen were matched 1:1 by propensity scoring with nine variables to evaluate differences in HCC incidence. The median observation period was 3.5 years. Sixty-nine cases of HCC were found during 5483.9 person-years (PY) over the entire follow-up period. The annual incidence was similar for both groups (SOF-based 1.25 and SOF-free 1.27 per 100 PY, respectively: adjusted hazard ratio (HR) 1.26, 95% confidence interval (CI) 0.75–2.12, p = 0.39). However, the annual incidence within the first two years was higher for patients treated with SOF than for those without, but did not reach significance (1.50 and 0.97 per 100 PY incidence rates, respectively: adjusted HR 2.05, 95% CI 0.98–4.25, p = 0.06). In summary, DAA treatment with SOF was not associated with an increase in the development of de novo HCC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence of Hepatocellular Carcinoma after Treatment with Sofosbuvir-Based or Sofosbuvir-Free Regimens in Patients with Chronic Hepatitis C

Ogawa

Nomura

Nakamuta

et al. 2020

Cancers

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“…Finally, LSM by VCTE and VITRO not only predict the presence of CSPH after etiological cure, but may also indicate the risk of CSPH-related complications in the narrow sense, as well as HCC. A study by Pons et al 119 found that in cACLD patients, HCC development is substantially more common than hepatic decompensation in the post-SVR setting. Although two studies 120,121 linked high pretreatment LSM (i.e., > 21.3 kPa and > 30 kPa) with an increased risk of posttreatment HCC, in another study by Ravaioli and coworkers, there were no differences in pretreatment LSM between patients with HCC development posttreatment, or without.…”

Section: Monitoring the Evolution Of Portal Hypertension And Predictimentioning

confidence: 99%

“…However, patients who developed HCC had less pronounced absolute decreases in LSM, resulting in lower posttreatment LSM values. 122 Pons et al 119 found that posttreatment LSM is the main determinant of HCC development after successful antiviral therapy, as patients with LSM values ! 20 kPa (i.e., values indicative of persistent CSPH) were at highest risk.…”

Section: Monitoring the Evolution Of Portal Hypertension And Predictimentioning

confidence: 99%

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

et al. 2020

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Noninvasive diagnostics for portal hypertension include imaging and functional tests, as well as blood-based biomarkers, and capture different features of the portal hypertensive syndrome. Definitive conclusions regarding their clinical utility require assessment of their diagnostic value in specific clinical settings (i.e., diagnosing a particular hemodynamic condition within a well-defined target population). Several noninvasive methods are predictive of clinically significant portal hypertension (CSPH; hepatic venous pressure gradient [HVPG] ≥ 10 mm Hg; the threshold for complications of portal hypertension); however, only a minority of them have been evaluated in compensated advanced chronic liver disease (i.e., the target population). Importantly, most methods correlate only weakly with HVPG at high values (i.e., in patients with CSPH). Nevertheless, selected methods show promise for diagnosing HVPG ≥ 16 mm Hg (the cut-off for increased risks of hepatic decompensation and mortality) and monitoring HVPG changes in response to nonselective beta-blockers or etiological treatments. Finally, we review established and potential future clinical applications of noninvasive methods.

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“…We really appreciate Charette et al's 1 interest in our study. 2 We would like to clarify, that our initial aim was to identify a subpopulation among compensated advanced chronic liver disease (cACLD) patients with cured HCV who could avoid hepatocellular carcinoma (HCC) surveillance because of a very low risk of developing HCC during follow up; unfortunately, we failed. All such patients need continued HCC screening.…”

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confidence: 99%

Reply to: “Evaluating the role of transient elastography post chronic hepatitis C treatment to predict hepatocellular carcinoma”

Genescà

2020

Journal of Hepatology

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Non-invasive prediction of liver-related events in patients with HCV-associated compensated advanced chronic liver disease after oral antivirals

Cited by 144 publications

References 29 publications

Incidence of Hepatocellular Carcinoma after Treatment with Sofosbuvir-Based or Sofosbuvir-Free Regimens in Patients with Chronic Hepatitis C

Incidence of Hepatocellular Carcinoma after Treatment with Sofosbuvir-Based or Sofosbuvir-Free Regimens in Patients with Chronic Hepatitis C

Noninvasive Diagnostics for Portal Hypertension: A Comprehensive Review

Reply to: “Evaluating the role of transient elastography post chronic hepatitis C treatment to predict hepatocellular carcinoma”

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