TY - JOUR
T1 - Association between steatohepatitis biomarkers and hepatocellular carcinoma after hepatitis C elimination
AU - Ogawa, Eiichi
AU - Takayama, Koji
AU - Hiramine, Satoshi
AU - Hayashi, Takeo
AU - Toyoda, Kazuhiro
N1 - Funding Information:
This work was supported by JSPS KAKENHI Grant Number 20K08820. We are grateful to Mr Yoshitaka Etoh for his excellent lab work on the PNPLA3 gene rs738409 testing, Ms Noriko Iwasaki for supporting the data analysis, and Drs. Norihiro Furusyo, Masayuki Murata, Hiroaki Ikezaki, Sho Yamasaki, Takatsugu Ueyama, Azusa Ohta, Yuji Matsumoto and Ken Yamamoto of the Department of General Internal Medicine of Kyushu University Hospital for collecting the data. Declaration of personal interests: All authors declare that they have no conflicts of interest.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: A strong association between chronic hepatitis C (CHC) and hepatic steatosis has been reported. However, the influence of steatohepatitis on hepatocellular carcinoma (HCC) after hepatitis C virus (HCV) elimination remains unclear. Aim: To evaluate the development of HCC after HCV cure using a new steatohepatitis-related biomarker. Methods: This cohort study analysed the prospective database of 290 CHC patients without a history of HCC who achieved HCV elimination by direct-acting antivirals. We calculated the FibroScan-aspartate aminotransferase (FAST) score 12 weeks after the end of treatment (pw12). The risk of HCC was analysed using the multivariable Cox proportional hazard model. Results: HCV genotype (GT)1 was most prevalent at 72.4%, followed by GT2 (26.6%). Median follow-up period was 4.2 years (IQR 3.1-4.5). The cumulative HCC incidence for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35 (log-rank test: P < 0.001). The annual HCC incidence rate for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35, in patients with liver stiffness measurement (LSM) ≥10 kPa (adjusted hazard ratio [HR] 4.41, 95% confidence interval [CI] 1.30-15.0, P = 0.018). After adjusting for variables, including age, albumin, alpha-fetoprotein, the patatin-like phospholipase domain-containing the 3 (PNPLA3) rs738409 genotype, and pw12 fibrosis markers with FIB-4, non-alcoholic fatty liver disease fibrosis score, and LSM, FAST score ≥ 0.35 was associated with the development of HCC (adjusted HR 4.42, 95% CI 1.02-19.9, P = 0.043). Conclusions: Steatohepatitis-related biomarkers with the FAST score are helpful for predicting the development of HCC after HCV elimination.
AB - Background: A strong association between chronic hepatitis C (CHC) and hepatic steatosis has been reported. However, the influence of steatohepatitis on hepatocellular carcinoma (HCC) after hepatitis C virus (HCV) elimination remains unclear. Aim: To evaluate the development of HCC after HCV cure using a new steatohepatitis-related biomarker. Methods: This cohort study analysed the prospective database of 290 CHC patients without a history of HCC who achieved HCV elimination by direct-acting antivirals. We calculated the FibroScan-aspartate aminotransferase (FAST) score 12 weeks after the end of treatment (pw12). The risk of HCC was analysed using the multivariable Cox proportional hazard model. Results: HCV genotype (GT)1 was most prevalent at 72.4%, followed by GT2 (26.6%). Median follow-up period was 4.2 years (IQR 3.1-4.5). The cumulative HCC incidence for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35 (log-rank test: P < 0.001). The annual HCC incidence rate for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35, in patients with liver stiffness measurement (LSM) ≥10 kPa (adjusted hazard ratio [HR] 4.41, 95% confidence interval [CI] 1.30-15.0, P = 0.018). After adjusting for variables, including age, albumin, alpha-fetoprotein, the patatin-like phospholipase domain-containing the 3 (PNPLA3) rs738409 genotype, and pw12 fibrosis markers with FIB-4, non-alcoholic fatty liver disease fibrosis score, and LSM, FAST score ≥ 0.35 was associated with the development of HCC (adjusted HR 4.42, 95% CI 1.02-19.9, P = 0.043). Conclusions: Steatohepatitis-related biomarkers with the FAST score are helpful for predicting the development of HCC after HCV elimination.
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U2 - 10.1111/apt.15976
DO - 10.1111/apt.15976
M3 - Article
C2 - 32697871
AN - SCOPUS:85088287317
VL - 52
SP - 866
EP - 876
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
IS - 5
ER -