Increased risk for hepatocellular carcinoma persists up to 10 years after HCV eradication in patients with baseline cirrhosis or high FIB-4 scores
Gastroenterology Aug 01, 2019
Ioannou GN, Beste LA, Green PK, et al. - Whether the risk of hepatocellular carcinoma (HCC) decreases over time following hepatitis C virus (HCV) eradication is not clear, so researchers evaluated changes in annual HCC incidence overtime after HCV eradication and recognized dynamic HCC risk markers. Forty-eight thousand one hundred thirty-five patients who started HCV antiviral treatment from 2000 through 2015 and achieved a sustained virologic response (SVR) in the Veterans Health Administration (29,033 treated with direct-acting antiviral (DAA) agents and 19,102 treated with interferon-based regimens) were identified. According to findings, cirrhosis patients with HCV infection treatment prior to an SVR continue to be at high risk for HCC (> 2%/year) for several years, even if their fibrosis-4 (FIB-4) score decreases and they should continue to be monitored. Patients without cirrhosis but with FIB-4 scores ≥3.25 have a sufficiently high risk to warrant HCC monitoring, particularly if FIB-4 remains ≥3.25 post-SVR.
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