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Effect of interferon-based and -free therapy on early occurrence and recurrence of hepatocellular carcinoma in chronic hepatitis C.

Authors
  • Nagata, Hiroko1
  • Nakagawa, Mina2
  • Asahina, Yasuhiro3
  • Sato, Ayako1
  • Asano, Yu1
  • Tsunoda, Tomoyuki1
  • Miyoshi, Masato1
  • Kaneko, Shun1
  • Otani, Satoshi1
  • Kawai-Kitahata, Fukiko4
  • Murakawa, Miyako5
  • Nitta, Sayuri1
  • Itsui, Yasuhiro4
  • Azuma, Seishin1
  • Kakinuma, Sei6
  • Nouchi, Toshihiko7
  • Sakai, Hideki8
  • Tomita, Makoto9
  • Watanabe, Mamoru1
  • 1 Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan. , (Japan)
  • 2 Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan; Institute of Education, Tokyo Medical and Dental University, Japan. , (Japan)
  • 3 Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan; Department of Liver Disease Control, Tokyo Medical and Dental University, Japan. Electronic address: [email protected] , (Japan)
  • 4 Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan; Department of General Medicine, Tokyo Medical and Dental University, Japan. , (Japan)
  • 5 Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan; Department of Clinical Laboratory, Tokyo Medical and Dental University, Japan. , (Japan)
  • 6 Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Japan; Department of Liver Disease Control, Tokyo Medical and Dental University, Japan. , (Japan)
  • 7 Showa General Hospital, Tokyo Medical and Dental University, Tokyo, Japan. , (Japan)
  • 8 Kashiwa Municipal Hospital, Tokyo Medical and Dental University, Tokyo, Japan. , (Japan)
  • 9 Clinical Research Center, Tokyo Medical and Dental University, Tokyo, Japan. , (Japan)
Type
Published Article
Journal
Journal of hepatology
Publication Date
Nov 01, 2017
Volume
67
Issue
5
Pages
933–939
Identifiers
DOI: 10.1016/j.jhep.2017.05.028
PMID: 28627363
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Although treatment for hepatitis C virus has been dramatically improved by the development of direct-acting antiviral agents (DAAs), whether interferon (IFN)-free therapy reduces hepatocarcinogenesis in an equivalent manner to IFN-based therapy remains controversial. The aims of this study were to evaluate the occurrence and recurrence of hepatocellular carcinoma (HCC) in chronic hepatitis C (CHC) patients treated with DAAs and to identify biomarkers of HCC development after antiviral treatment. A restrospective review of a prospective database of 1,897 CHC patients who were treated with IFN-based (1,145) or IFN-free therapies (752) was carried out. Cumulative HCC occurrence and recurrence rates were compared using propensity score-matched analysis. Predictors of HCC development after viral eradication were identified by multivariate analysis. Propensity score-matched analysis showed no significant difference in HCC occurrence (p=0.49) and recurrence rates (p=0.54) between groups treated with IFN-based or IFN-free therapies. In multivariate analysis, higher levels of post-treatment α-fetoprotein (AFP) or Wisteria floribunda agglutinin positive Mac-2 binding protein (WFA+M2BP) were independently associated with HCC occurrence and recurrence after viral eradication. Only post-treatment WFA+M2BP level was significantly associated with HCC occurrence and recurrence among patients without severe fibrosis. The area under the receiver operating characteristic (ROC) curve for WFA+M2BP levels was greater than that for AFP levels in ROC analysis. The risks of early HCC occurrence and recurrence after viral eradication were similar between IFN-based and IFN-free therapies. Post-treatment levels of WFA+M2BP may be helpful screening biomarkers for assessing the risk of HCC after IFN-free therapy. Patients with high WFA+M2BP levels after antiviral treatment, even without severe fibrosis, must be followed up carefully for HCC development. Lay summary: The risks of early HCC occurrence and recurrence after viral eradication were similar between IFN-based and IFN-free therapies. Post-treatment levels of WFA+M2BP may be helpful screening biomarkers for assessing the risk of HCC after IFN-free therapy. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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