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Article: HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort

TitleHCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort
Authors
KeywordsAsia
Ethnicity
Liver cancer
Surveillance
Real-world
Issue Date2020
PublisherSpringer (India) Private Ltd. The Journal's web site is located at http://www.springer.com/medicine/internal/journal/12072
Citation
Hepatology International, 2020, v. 14 n. 6, p. 1023-1033 How to Cite?
AbstractBackground: Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients. Methods: To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups. Results: In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94, p < 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41, p = 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5, p < 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6, p = 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26, p = 0.005). Conclusions: Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.
Persistent Identifierhttp://hdl.handle.net/10722/305386
ISSN
2023 Impact Factor: 5.9
2023 SCImago Journal Rankings: 1.813
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTanaka,, Y-
dc.contributor.authorOgawa, E-
dc.contributor.authorHuang, CF-
dc.contributor.authorToyoda, H-
dc.contributor.authorJun, DW-
dc.contributor.authorTseng, CH-
dc.contributor.authorHsu, YC-
dc.contributor.authorEnomoto, M-
dc.contributor.authorTakahashi, H-
dc.contributor.authorFurusyo, N-
dc.contributor.authorYeh, ML-
dc.contributor.authorlio, E-
dc.contributor.authorYasuda, S-
dc.contributor.authorLam, CPM-
dc.contributor.authorLee, DH-
dc.contributor.authorHaga, H-
dc.contributor.authorYoon, EL-
dc.contributor.authorAhn, SB-
dc.contributor.authorWong, G-
dc.contributor.authorNakamuta, M-
dc.contributor.authorNomura, H-
dc.contributor.authorTsai, PC-
dc.contributor.authorJung, JH-
dc.contributor.authorSong, DS-
dc.contributor.authorDang, H-
dc.contributor.authorMaeda, M-
dc.contributor.authorHenry, L-
dc.contributor.authorCheung, R-
dc.contributor.authorYuen, MF-
dc.contributor.authorUeno, Y-
dc.contributor.authorEguchi, Y-
dc.contributor.authorTamori, A-
dc.contributor.authorYu, ML-
dc.contributor.authorHayashi, J-
dc.contributor.authorNguyen, MH-
dc.date.accessioned2021-10-20T10:08:40Z-
dc.date.available2021-10-20T10:08:40Z-
dc.date.issued2020-
dc.identifier.citationHepatology International, 2020, v. 14 n. 6, p. 1023-1033-
dc.identifier.issn1936-0533-
dc.identifier.urihttp://hdl.handle.net/10722/305386-
dc.description.abstractBackground: Despite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients. Methods: To address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups. Results: In the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94, p < 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41, p = 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5, p < 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6, p = 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26, p = 0.005). Conclusions: Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.-
dc.languageeng-
dc.publisherSpringer (India) Private Ltd. The Journal's web site is located at http://www.springer.com/medicine/internal/journal/12072-
dc.relation.ispartofHepatology International-
dc.rightsAccepted Manuscript (AAM) This is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI]-
dc.subjectAsia-
dc.subjectEthnicity-
dc.subjectLiver cancer-
dc.subjectSurveillance-
dc.subjectReal-world-
dc.titleHCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort-
dc.typeArticle-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s12072-020-10105-2-
dc.identifier.pmid33277685-
dc.identifier.scopuseid_2-s2.0-85097134034-
dc.identifier.hkuros326989-
dc.identifier.volume14-
dc.identifier.issue6-
dc.identifier.spage1023-
dc.identifier.epage1033-
dc.identifier.isiWOS:000599006000001-
dc.publisher.placeIndia-

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