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Conference Paper: 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
Issue Date2020
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
The Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): The Liver Meeting Digital Experience 2020, Boston, USA, 13-16 November 2020. In Hepatology, 2020, v. 72 n. S1, p. 34A-36A, abstract no. 46 How to Cite?
AbstractBackground: Despite HCV cure, patients remain at risk for HCC. Current evidence has provided some data on risk factors; however, due to a paucity of data from Asia, the generalizability of these findings has not been established. To address this gap, we determined HCC incidence post-SVR and risk factors in a large cohort from East Asia. Methods: Data were obtained from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) registry to determine incidence of HCC. Eligible patients (no HCC within 6 months from DAA initiation, n=5814) were divided into SVR12 (n=5,646) and non-SVR12 groups (n=168). We used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and AFP] to balance the two groups, Kaplan-Meier methods to estimate cumulative incidence rates, and Cox proportional hazards regression modeling to identify predictors for HCC incidence. Results: Initial analysis of the overall cohort revealed significant differences between the two groups in certain characteristics. After the PSM, the two groups were well matched. In both the overall (168 non-SVR, 5,646 SVR) and PSM cohorts (160 non-SVR and 612 SVR), the incidence rate per 1000 person years was higher in the non-SVR (49.54 and 52.64) compared to the SVR group (16.62 and 19.4, respectively, P<0.001 for both). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.46 and 0.41, P=0.001 and 0.002, respectively). However, among SVR patients (Table), the 5-year cumulative HCC incidence were still very high among cirrhotic patients (>10% in those ≥ 60 years of age, higher ALBI grades, highest in those with elevated [≥ 10 ng /mL] pretreatment AFP [22.4%, 95% CI: 16.7-29.7]) and among noncirrhotic patients with elevated AFP levels (4.33%, 95% CI: 1.8-10.1). On multivariable regression analysis adjusted for the following factors, age ≥60, having an albumin bilirubin (ALBI) grade of 2 or 3 (aHR: 2.5, P<0.001), and AFP ≥ 10 ng /mL (aHR: 1.6, P=0.001) were independently associated with higher HCC risk among cirrhotic SVR patients, while only AFP ≥ 10 ng /mL was significant among non-cirrhotic SVR patients (aHR: 4.26, P=0.005). Conclusion: Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Baseline AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.
DescriptionOral Presentation - no. 46
Persistent Identifierhttp://hdl.handle.net/10722/307562
ISSN
2023 Impact Factor: 12.9
2023 SCImago Journal Rankings: 5.011

 

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, C-
dc.contributor.authorLee, DH-
dc.contributor.authorHaga, H-
dc.contributor.authorYoon, E-
dc.contributor.authorAhn, SB-
dc.contributor.authorWong, GLH-
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, RMF-
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.contributor.authorAzuma, K-
dc.contributor.authorChuang, WL-
dc.contributor.authorDai, CY-
dc.contributor.authorDohmen, K-
dc.contributor.authorHuang, JF-
dc.contributor.authorJun, M-
dc.contributor.authorKajiwara, E-
dc.contributor.authorKato, M-
dc.contributor.authorKawano, A-
dc.contributor.authorKoyanagi, T-
dc.contributor.authorLee, MH-
dc.contributor.authorOoho, A-
dc.contributor.authorSatoh, T-
dc.contributor.authorShimoda, S-
dc.contributor.authorTakahashi, K-
dc.contributor.authorYang, H-I-
dc.date.accessioned2021-11-04T02:45:20Z-
dc.date.available2021-11-04T02:45:20Z-
dc.date.issued2020-
dc.identifier.citationThe Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): The Liver Meeting Digital Experience 2020, Boston, USA, 13-16 November 2020. In Hepatology, 2020, v. 72 n. S1, p. 34A-36A, abstract no. 46-
dc.identifier.issn0270-9139-
dc.identifier.urihttp://hdl.handle.net/10722/307562-
dc.descriptionOral Presentation - no. 46-
dc.description.abstractBackground: Despite HCV cure, patients remain at risk for HCC. Current evidence has provided some data on risk factors; however, due to a paucity of data from Asia, the generalizability of these findings has not been established. To address this gap, we determined HCC incidence post-SVR and risk factors in a large cohort from East Asia. Methods: Data were obtained from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) registry to determine incidence of HCC. Eligible patients (no HCC within 6 months from DAA initiation, n=5814) were divided into SVR12 (n=5,646) and non-SVR12 groups (n=168). We used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and AFP] to balance the two groups, Kaplan-Meier methods to estimate cumulative incidence rates, and Cox proportional hazards regression modeling to identify predictors for HCC incidence. Results: Initial analysis of the overall cohort revealed significant differences between the two groups in certain characteristics. After the PSM, the two groups were well matched. In both the overall (168 non-SVR, 5,646 SVR) and PSM cohorts (160 non-SVR and 612 SVR), the incidence rate per 1000 person years was higher in the non-SVR (49.54 and 52.64) compared to the SVR group (16.62 and 19.4, respectively, P<0.001 for both). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.46 and 0.41, P=0.001 and 0.002, respectively). However, among SVR patients (Table), the 5-year cumulative HCC incidence were still very high among cirrhotic patients (>10% in those ≥ 60 years of age, higher ALBI grades, highest in those with elevated [≥ 10 ng /mL] pretreatment AFP [22.4%, 95% CI: 16.7-29.7]) and among noncirrhotic patients with elevated AFP levels (4.33%, 95% CI: 1.8-10.1). On multivariable regression analysis adjusted for the following factors, age ≥60, having an albumin bilirubin (ALBI) grade of 2 or 3 (aHR: 2.5, P<0.001), and AFP ≥ 10 ng /mL (aHR: 1.6, P=0.001) were independently associated with higher HCC risk among cirrhotic SVR patients, while only AFP ≥ 10 ng /mL was significant among non-cirrhotic SVR patients (aHR: 4.26, P=0.005). Conclusion: Achieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Baseline 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.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/-
dc.relation.ispartofHepatology-
dc.relation.ispartofThe Annual Meeting of the American Association for the Study of Liver Diseases (AASLD): The Liver Meeting Digital Experience 2020-
dc.titleHCC Risk Post-SVR with DAAS in East Asians: Findings from the Real-C Cohort-
dc.typeConference_Paper-
dc.identifier.emailYuen, RMF: mfyuen@hku.hk-
dc.identifier.authorityYuen, RMF=rp00479-
dc.description.natureabstract-
dc.identifier.hkuros326937-
dc.identifier.volume72-
dc.identifier.issueS1-
dc.identifier.spage34A-
dc.identifier.epage36A-
dc.publisher.placeUnited States-
dc.identifier.partofdoi10.1002/hep.31578-

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