☆ 4.7 Review

Risk of Hepatocellular Carcinoma After Spontaneous Clearance of Hepatitis C Virus and in Noncirrhosis Chronic Hepatitis C Patients With Sustained Virological Response: A Systematic Review

CLINICAL INFECTIOUS DISEASES (2023)

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Summary: Pooled estimates from meta-analysis showed that the incidence of hepatocellular carcinoma (HCC) after sustained virologic response (SVR) in patients with cirrhosis was very high (2.99/100 person-years). However, this incidence may decline with longer time after SVR. In patients without cirrhosis, including those with F3 fibrosis, the incidence of HCC was lower than the thresholds for cost-effective HCC screening. There was little heterogeneity among studies in patients with F3 fibrosis, suggesting that HCC screening may not be warranted.

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Risk factors for HCC in contemporary cohorts of patients with cirrhosis

Fasiha Kanwal et al.

Summary: This study investigated the risk of developing HCC in patients with cirrhosis and found that the incidence rate of HCC was lower than previously reported. The risk of HCC varied depending on the etiology, with higher risk in patients with cured HCV and lower risk in those with NAFLD. Current smoking and overweight/obesity were also associated with increased HCC risk.

HEPATOLOGY (2023)

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Longitudinal changes in fibrosis markers are associated with risk of cirrhosis and hepatocellular carcinoma in non- alcoholic fatty liver disease

George Cholankeril et al.

Summary: This study aimed to analyze the association between longitudinal changes in fibrosis-4 (FIB-4) score and the subsequent risk of cirrhosis and hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD). Results from a retrospective cohort study showed that longitudinal changes in FIB-4 were strongly associated with the progression to cirrhosis and HCC.

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Article Gastroenterology & Hepatology

Isolated Hepatitis B Core Antibody Positivity and Long-Term Liver-Related Mortality in Korea: A Cohort Study

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Summary: This study investigated whether isolated hepatitis B core antibody (anti-HBc) positivity is a risk factor for long-term liver-related outcomes in Korean adults. The study found that isolated anti-HBc positivity is associated with liver-related and liver cancer mortality, especially when accompanied by a high fibrosis score.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2023)

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Features of patients who developed hepatocellular carcinoma after direct-acting antiviral treatment for hepatitis C Virus

Seiichi Mawatari et al.

Summary: This study aimed to investigate the characteristics of hepatitis C virus patients who developed hepatocellular carcinoma (HCC) after receiving direct-acting antiviral therapy and achieving a sustained virologic response. The study found that certain factors, such as age, sex, levels of hyaluronic acid, alpha-fetoprotein at the end of treatment, and albumin at the end of treatment, were associated with the development of HCC.

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Risk of hepatocellular carcinoma after sustained virologic response in hepatitis C virus patients without advanced liver fibrosis

Yuki Tahata et al.

Summary: This study developed a scoring system to predict the incidence of HCC after SVR in HCV patients without advanced liver fibrosis, using baseline age, ALT levels at SVR, and AFP levels at SVR as independent predictors. The system proved to be useful for post-SVR HCC surveillance in patients without advanced liver fibrosis.

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Factors linked to hepatocellular carcinoma development beyond 10 years after viral eradication in patients with hepatitis C virus

Takashi Kumada et al.

Summary: The risk factors for hepatocellular carcinoma (HCC) development in patients with sustained virological response (SVR) duration of over 10 years remain unclear. The annual incidence rates of HCC development within 10 years and beyond 10 years after SVR were 0.568% and 0.190% respectively. Factors such as male gender, fibrosis-4 (FIB-4) score > 3.25, and alpha-fetoprotein >= 5.0 ng/ml were independently associated with HCC development within 10 years after SVR, while factors such as male gender, presence of diabetes mellitus, and elevated gamma-glutamyl transpeptidase (GGT) were independently associated with HCC development beyond 10 years after SVR.

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Jennifer R. Kramer et al.

Summary: This study examined the risk factors for hepatocellular carcinoma (HCC) in patients with virologically cured hepatitis C virus (HCV) infection, and found that the risk factors differed between patients with and without cirrhosis, and some factors evolved over time. These factors can help with risk stratification and decisions on HCC surveillance in patients with cured HCV.

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Daniel Q. Huang et al.

Summary: The prevalence of NAFLD-related HCC is projected to continue rising globally, with NASH expected to increase and obesity as a major risk factor. Urgent measures are needed to address this growing problem.

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Hepatocellular carcinoma risk after viral response in hepatitis C virus-advanced fibrosis: Who to screen and for how long?

Adriana Ahumada et al.

Summary: Chronic hepatitis C virus (HCV) infection is closely related to the development of hepatocellular carcinoma (HCC), and lifelong surveillance is recommended even after sustained virological response (SVR), although not all patients have the same risk. Efforts have been made to develop predictive models and risk calculators to identify patients with very low HCC risk.

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Prediction of Hepatocellular Carcinoma by Liver Stiffness Measurements Using Magnetic Resonance Elastography After Eradicating Hepatitis C Virus

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Summary: This study evaluated the significance of liver stiffness measured by MRE in predicting the risk of developing HCC in patients who achieved SVR through DAAs therapy. The results indicated that an MRE value >= 4.5 kPa was independently associated with HCC development, highlighting the importance of MRE in HCC risk stratification.

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HCV-Induced Epigenetic Changes Associated With Liver Cancer Risk Persist After Sustained Virologic Response

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Hepatitis C virus leaves an epigenetic signature post cure of infection by direct-acting antivirals

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Shear wave elastography predicts hepatocellular carcinoma risk in hepatitis C patients after sustained virological response

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