慢性丙型肝炎直接抗病毒治疗后新生肝细胞癌的发生率:前瞻性随访。

Shahid Rasool, Sofia Hanif, Aneeqa Ahmad, Umair Shafqat, Ahmad Nawaz Babar
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引用次数: 0

摘要

背景:在获得直接作用抗病毒药物(DAAs)后,慢性丙型肝炎(CHC)的管理发生了巨大变化。持续病毒学应答(SVR)已显著改善,但主要关注的问题之一是DAAs后新发肝细胞癌(HCC)的可能性。本研究的目的是计算巴基斯坦CHC抗病毒治疗后新诊断的HCC病例的频率。材料和方法:这项前瞻性介入研究于2017年6月至2020年9月进行。所有CHC抗病毒治疗后的患者均接受腹部超声检查和甲胎蛋白检查,随访时间为6个月。对可疑病例进行腹部多期计算机断层扫描(CT)。对于定量变量,计算平均值和标准差,而定性变量则通过频率和百分比进行分析。结果:180例患者中,男性110例,女性70例,平均年龄45.52±11.71岁。126例患者为非肝硬化,38例为代偿性肝硬化,16例为失代偿性肝硬化。一百六十四名(91.11%)患者实现了SVR,其中22名(12.22%)患者在随访中出现了新的HCC。代偿性肝硬化组有10例,失代偿组有12例,非肝硬化组没有新的HCC病例。在新发HCC患者中,有12例实现了SVR。结论:肝硬化患者在抗病毒治疗后发展为HCC的风险非常显著。因此,在每一位使用DAA药物治疗后的肝硬化患者中,即使他们达到了SVR,也应该采取严格的监测策略。临床意义:即使在肝硬化患者中使用DAA达到SVR后,发生HCC的几率仍然非常高。即使在DAAs治疗后达到SVR,肝硬化患者也应接受HCC监测。如何引用这篇文章:Rasool S,Hanif S,Ahmad A等。慢性丙型肝炎直接作用抗病毒治疗后De Novo肝细胞癌的发生率:前瞻性随访。欧亚国际肝病杂志2022;12(2):73-76。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Frequency of <i>De Novo</i> Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up.

Frequency of <i>De Novo</i> Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up.

Frequency of De Novo Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up.

Background: Chronic hepatitis C (CHC) management has changed tremendously after direct-acting antivirals (DAAs) availability. Sustained virological response (SVR) has improved significantly, but one of the major concerns is the chances of de novo hepatocellular carcinoma (HCC) development after DAAs. The objective of the study is to calculate the frequency of newly diagnosed cases of HCC after antiviral therapy for CHC in Pakistan.

Materials and methods: This prospective, interventional research was conducted from June 2017 to September 2020. All patients after antiviral therapy for CHC were followed with an ultrasound abdomen and α-fetoprotein, six monthly. Multiphasic computed tomography (CT) of the abdomen was performed in suspected cases. For quantitative variables, the mean and standard deviations were calculated, whereas the qualitative variables were analyzed by frequencies and percentages.

Results: Among 180 patients, 110 were men and 70 were women with a mean age of 45.52 ± 11.71 years. One hundred and twenty-six patients were noncirrhotic, 38 had compensated cirrhosis while 16 had decompensated cirrhosis. One hundred and sixty-four (91.11%) patients achieved SVR, of which 22 (12.22%) patients developed new HCC during follow-up. Compensated cirrhosis group had 10 patients, the decompensated group had 12 patients, and the noncirrhotic group had no new HCC cases. Among patients with the new HCC, 12 achieved SVR.

Conclusion: The risk of the development of HCC after antiviral treatment is highly significant among patients with liver cirrhosis. So, a strict surveillance strategy should be adopted in every cirrhotic patient following treatment with DAA agents even if they achieve SVR.

Clinical significance: Chances of developing HCC are still significantly high even after achieving SVR with DAAs in patients with liver cirrhosis.Patients with liver cirrhosis should be under surveillance for HCC even after achieving SVR after DAAs treatment.

How to cite this article: Rasool S, Hanif S, Ahmad A, et al. Frequency of De Novo Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up. Euroasian J Hepato-Gastroenterol 2022;12(2):73-76.

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