代偿性晚期慢性肝病患者丙型肝炎病毒直接抗病毒药物根除后新发HCC的预测和监测

IF 2 Q4 VIROLOGY
Ashraf Elbahrawy, Hassan Atalla, Abdulla A. Mahmoud, Ahmed Eliwa, Alaa Alsawak, Mohamed Alboraie, Ali Madian, Ahmed Alashker, Sadek Mostafa, Ahmed Alwassief, Hussein H. Aly
{"title":"代偿性晚期慢性肝病患者丙型肝炎病毒直接抗病毒药物根除后新发HCC的预测和监测","authors":"Ashraf Elbahrawy, Hassan Atalla, Abdulla A. Mahmoud, Ahmed Eliwa, Alaa Alsawak, Mohamed Alboraie, Ali Madian, Ahmed Alashker, Sadek Mostafa, Ahmed Alwassief, Hussein H. Aly","doi":"10.3389/fviro.2023.1227317","DOIUrl":null,"url":null,"abstract":"The risk of hepatocellular carcinoma (HCC) diminishes in patients with hepatitis C virus (HCV)-related advanced chronic liver disease after virological cure. However, despite viral clearance, HCV-induced epigenetic alterations, immune dysregulations, and hepatic parenchymal injuries remain, contributing to de novo HCC occurrence. While HCC incidence is low (0.45 – 0.5%) in patients with advanced fibrosis (F3), the presence of liver cirrhosis and clinically significant portal hypertension increases the HCC risk. The cost-effectiveness of lifelong HCC surveillance in patients with compensated advanced chronic liver disease (cACLD) has sparked debate, raising questions about the most reliable noninvasive tests and stratification models for predicting HCC in patients with sustained virological response (SVR). Furthermore, identifying cACLD patients who may not require long-term HCC surveillance after SVR remains crucial. Several HCC risk stratification scores have been suggested for patients with cACLD, and emerging evidence supports individualized care based on personalized risk assessments. This review focuses on revising the pretreatment and posttreatment predictors of HCC, as well as the indications for HCC surveillance in cACLD patients treated with direct-acting antivirals.","PeriodicalId":73114,"journal":{"name":"Frontiers in virology","volume":"2017 4","pages":"0"},"PeriodicalIF":2.0000,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prediction and surveillance of de novo HCC in patients with compensated advanced chronic liver disease after hepatitis C virus eradication with direct antiviral agents\",\"authors\":\"Ashraf Elbahrawy, Hassan Atalla, Abdulla A. Mahmoud, Ahmed Eliwa, Alaa Alsawak, Mohamed Alboraie, Ali Madian, Ahmed Alashker, Sadek Mostafa, Ahmed Alwassief, Hussein H. Aly\",\"doi\":\"10.3389/fviro.2023.1227317\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The risk of hepatocellular carcinoma (HCC) diminishes in patients with hepatitis C virus (HCV)-related advanced chronic liver disease after virological cure. However, despite viral clearance, HCV-induced epigenetic alterations, immune dysregulations, and hepatic parenchymal injuries remain, contributing to de novo HCC occurrence. While HCC incidence is low (0.45 – 0.5%) in patients with advanced fibrosis (F3), the presence of liver cirrhosis and clinically significant portal hypertension increases the HCC risk. The cost-effectiveness of lifelong HCC surveillance in patients with compensated advanced chronic liver disease (cACLD) has sparked debate, raising questions about the most reliable noninvasive tests and stratification models for predicting HCC in patients with sustained virological response (SVR). Furthermore, identifying cACLD patients who may not require long-term HCC surveillance after SVR remains crucial. Several HCC risk stratification scores have been suggested for patients with cACLD, and emerging evidence supports individualized care based on personalized risk assessments. This review focuses on revising the pretreatment and posttreatment predictors of HCC, as well as the indications for HCC surveillance in cACLD patients treated with direct-acting antivirals.\",\"PeriodicalId\":73114,\"journal\":{\"name\":\"Frontiers in virology\",\"volume\":\"2017 4\",\"pages\":\"0\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2023-10-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in virology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fviro.2023.1227317\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"VIROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in virology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fviro.2023.1227317","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"VIROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

丙型肝炎病毒(HCV)相关晚期慢性肝病患者病毒学治愈后发生肝细胞癌(HCC)的风险降低。然而,尽管病毒清除,hcv诱导的表观遗传改变、免疫失调和肝实质损伤仍然存在,导致HCC的新发发生。虽然晚期纤维化患者的HCC发生率较低(0.45 - 0.5%)(F3),但肝硬化和临床显著的门静脉高压症的存在增加了HCC的风险。代偿性晚期慢性肝病(cACLD)患者终身HCC监测的成本效益引发了争论,提出了关于预测持续病毒学反应(SVR)患者HCC最可靠的无创伤检测和分层模型的问题。此外,确定SVR后可能不需要长期HCC监测的cACLD患者仍然至关重要。一些HCC风险分层评分已被建议用于cACLD患者,并且新出现的证据支持基于个性化风险评估的个性化护理。本文主要综述了HCC治疗前和治疗后的预测指标,以及直接作用抗病毒药物治疗的cACLD患者HCC监测的指征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prediction and surveillance of de novo HCC in patients with compensated advanced chronic liver disease after hepatitis C virus eradication with direct antiviral agents
The risk of hepatocellular carcinoma (HCC) diminishes in patients with hepatitis C virus (HCV)-related advanced chronic liver disease after virological cure. However, despite viral clearance, HCV-induced epigenetic alterations, immune dysregulations, and hepatic parenchymal injuries remain, contributing to de novo HCC occurrence. While HCC incidence is low (0.45 – 0.5%) in patients with advanced fibrosis (F3), the presence of liver cirrhosis and clinically significant portal hypertension increases the HCC risk. The cost-effectiveness of lifelong HCC surveillance in patients with compensated advanced chronic liver disease (cACLD) has sparked debate, raising questions about the most reliable noninvasive tests and stratification models for predicting HCC in patients with sustained virological response (SVR). Furthermore, identifying cACLD patients who may not require long-term HCC surveillance after SVR remains crucial. Several HCC risk stratification scores have been suggested for patients with cACLD, and emerging evidence supports individualized care based on personalized risk assessments. This review focuses on revising the pretreatment and posttreatment predictors of HCC, as well as the indications for HCC surveillance in cACLD patients treated with direct-acting antivirals.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信