The association between steatosis and diabetes with hepatocellular carcinoma in non‐genotype 3 chronic hepatitis C patients

Yen, Yi‐Hao; Lin, Meng‐Chih; Kuo, Fang-Ying; Chang, Kuo‐Chin; Tsai, Ming-Chao; Tseng, Po‐Lin; Wu, Cheng‐Kun; Lin, Jainn-Jim; Hu, Tsung–Hui; Lu, Sheng–Nan; Wang, Jing‐Houng; Hung, Chao‐Hung; Chen, Chien‐Hung

doi:10.1111/liv.13633

Cited by 14 publications

(10 citation statements)

References 37 publications

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“…77,78 Co-existing fatty liver is also a risk factor for Kawaguchi T et al P. 8 HCC after cure in patients with HCV infection. 79,80 Furthermore, Peleg et al demonstrated that fatty liver is a major predictor of all-cause mortality in patients who achieve a sustained virological response following DAA treatment, regardless of fibrosis stage. 81 Thus, MAFLD should be treated and managed on its own merits, even in patients with cured HCV infection.…”

Section: Importance Of Multiple Etiologies Of Liver Disease: Mafld Viral Hepatitis and Alcoholic Intakementioning

confidence: 99%

“…Treatment with DAAs reduces liver stiffness; however, this is negatively associated with an increase in the severity of fatty liver [ 77 , 78 ]. Co-existing fatty liver is also a risk factor for HCC after cure in patients with HCV infection [ 79 , 80 ]. Furthermore, Peleg et al [ 81 ] demonstrated that fatty liver is a major predictor of all-cause mortality in patients who achieve a sustained virological response following DAA treatment, regardless of fibrosis stage.…”

Section: Importance Of Multiple Etiologies Of Liver Disease: Mafld Vi...mentioning

confidence: 99%

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MAFLD enhances clinical practice for liver disease in the Asia-Pacific region

et al. 2022

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Fatty liver is now a major cause of liver disease in the Asia-Pacific region. Liver diseases in this region have distinctive characteristics. First, fatty liver is frequently observed in lean/normal-weight individuals. However, there is no standard definition of this unique phenotype. Second, fatty liver is often observed in patients with concomitant viral hepatitis. The exclusion of viral hepatitis from non-alcoholic fatty liver disease limits its value and detracts from the investigation and holistic management of coexisting fatty liver in patients with viral hepatitis. Third, fatty liver-associated hepatocellular carcinoma (HCC) is generally categorized as non-B non-C HCC. Fourth, the population is aging rapidly, and it is imperative to develop a practicable, low-intensity exercise program for elderly patients. Fifth, most patients and nonspecialized healthcare professionals still lack an awareness of the significance of fatty liver both in terms of intrahepatic and extrahepatic disease and cancer. Recently, an international expert panel proposed a new definition of fatty liver: metabolic dysfunction-associated fatty liver disease (MAFLD). One feature of MAFLD is that metabolic dysfunction is a prerequisite for diagnosis. Pertinent to regional issues, MAFLD also provides its diagnostic criteria in lean/normal-weight individuals. Furthermore, MAFLD is independent of any concomitant liver disease, including viral hepatitis. Therefore, MAFLD may be a more suitable definition for fatty liver in the Asia-Pacific region. In this review, we introduce the regional characteristics of fatty liver and discuss the advantages of MAFLD for improving clinical practice for liver disease in the region.

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Section: Importance Of Multiple Etiologies Of Liver Disease: Mafld Viral Hepatitis and Alcoholic Intakementioning

confidence: 99%

Section: Importance Of Multiple Etiologies Of Liver Disease: Mafld Vi...mentioning

confidence: 99%

MAFLD enhances clinical practice for liver disease in the Asia-Pacific region

et al. 2022

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“…The association between liver fibrosis and IFN‐λ3 levels shown in our results supports the possibility that IFN‐λ3 is induced during a fibrosis‐related immune response. In addition, there could be other causes of liver inflammation, such as liver steatosis or cellular senescence, as previously reported, although the association with liver fat or senescence‐associated secretory phenotypes was not evaluated in this study. Thus, it is possible that IFN‐λ3 might be induced by such chronic inflammation, which possibly promotes NHHN and HCC development after HCV clearance.…”

Section: Discussionmentioning

confidence: 83%

Association of serum interferon‐λ3 levels with hepatocarcinogenesis in chronic hepatitis C patients treated with direct‐acting antiviral agents

Inoue-Shinomiya

Murakawa

Asahina

et al. 2019

Hepatology Research

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Aim Although the efficacy of hepatitis C virus (HCV) treatment is improved dramatically by direct‐acting antiviral agents (DAAs), the assessment of hepatocellular carcinoma (HCC) remains important. Interferon lambda 3 (IFN‐λ3) is associated with liver fibrosis and inflammation in chronic hepatitis C (CHC) patients, but its impact on carcinogenesis remains controversial and little is known about its effects after viral clearance. To determine the contribution of IFN‐λ3 to hepatocarcinogenesis after HCV clearance, we analyzed IFNL3 genotypes and serial serum IFN‐λ3 levels in CHC patients who achieved sustained virologic responses (SVR). Methods This study comprised 201 CHC patients treated with DAAs. Serum samples were collected sequentially and IFN‐λ3 levels were quantified by chemiluminescence enzyme immunoassay. The IFNL3 polymorphism (rs8099917) was genotyped in 195 patients. Results One hundred and twenty‐five patients were rs8099917 T/T and 70 were non‐T/T. Serum IFN‐λ3 levels did not differ significantly with IFNL3 genotype, dropped markedly by 1 week and remained low up to 24 weeks after the end of treatment. Interferon‐λ3 levels were significantly higher after viral clearance in patients who developed HCC and were associated with a higher potential for hepatocarcinogenesis, such as a higher frequency of non‐hypervascular hypointensive nodules (P = 0.046), higher stages of liver fibrosis (P < 0.001), and higher post‐treatment levels of Wisteria floribunda agglutinin positive Mac‐2 binding protein (P < 0.001) and alanine aminotransferase (P < 0.001). Conclusions Serum IFN‐λ3 levels after HCV clearance are associated with the potential for HCC development. Interferon‐λ3 could be helpful for elucidating the relationships among immunologic status, liver fibrosis, liver inflammation, and hepatocarcinogenesis, after achieving SVR.

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“…Yen et al demonstrated that in addition to age, fibrosis stage, HCV genotype 1, steatosis and DM, either alone or in combination, were independent factors associated with HCC development in patients with CHC who had achieved SVR after pegylated interferon‐based therapy. These findings suggest that the prevalent severity of liver fibrosis and MS‐related steatosis is crucial to the future risk of HCC after HCV is eradicated 34 . Age, AST‐to‐ALT ratio and platelet count are frequently used for predicting the severity of liver fibrosis, and these variables are also components of FIB‐4 19,35 .…”

Section: Discussionmentioning

confidence: 99%

Posttreatment nonalcoholic fatty liver disease fibrosis scores for predicting liver‐related complications in patients with chronic hepatitis C receiving direct‐acting antiviral agents

Hsu

Lai

Chuang

et al. 2022

Journal of Viral Hepatitis

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Patients with chronic hepatitis C (CHC) have a higher prevalence of hepatic steatosis and dyslipidaemia than healthy individuals. We analysed noninvasive fibrosis assessments, especially nonalcoholic fatty liver disease (NAFLD)‐related noninvasive fibrosis tests, for predicting liver‐related complications and hepatocellular carcinoma (HCC) occurrence in patients with CHC. This retrospective study enrolled 590 consecutive patients with CHC having a sustained virologic response (SVR) to direct‐acting antiviral agent (DAA) therapy. The NAFLD fibrosis score (NFS) exhibiting the highest value of area under the receiver operating characteristic curve (AUROC) was selected for comparison with the fibrosis‐4 index (FIB‐4). Of the 590 patients, 188 had metabolic syndrome. A multivariate Cox regression analysis identified total bilirubin at 3 or 6 months after DAA therapy (PW12), NFS at PW12 (hazard ratio [HR]: 2.125, 95% confidence interval [CI]: 1.058–4.267, p = .034) and alpha‐fetoprotein (AFP) at PW12 (HR: 1.071, 95% CI: 1.005–1.142, p = .034) as the independent predictors of liver‐related complications in all patients. In patients with metabolic syndrome, NFS and AFP values at PW12 were independent predictors of liver‐related complications and HCC occurrence. Time‐dependent NFS AUROC values at PW12 for 1‐, 2‐ and 3‐year liver‐related complications were higher than NFS values at baseline in patients with metabolic syndrome. NFS at baseline or PW12 is a more effective predictor of liver‐related complications than FIB‐4 values in all patients. NFS at PW12 may be a useful predictor of liver‐related complications and HCC development in patients with CHC with an SVR to DAA therapy, especially in those with metabolic syndrome.

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The association between steatosis and diabetes with hepatocellular carcinoma in non‐genotype 3 chronic hepatitis C patients

Abstract: Steatosis and DM may be associated with HCC development in non-genotype 3 CHC patients with SVR.

Cited by 14 publications

References 37 publications

MAFLD enhances clinical practice for liver disease in the Asia-Pacific region

MAFLD enhances clinical practice for liver disease in the Asia-Pacific region

Association of serum interferon‐λ3 levels with hepatocarcinogenesis in chronic hepatitis C patients treated with direct‐acting antiviral agents

Posttreatment nonalcoholic fatty liver disease fibrosis scores for predicting liver‐related complications in patients with chronic hepatitis C receiving direct‐acting antiviral agents

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