Posted: Wednesday, November 23, 2022
Baseline age of 65 years or older—along with alanine aminotransferase levels of at least 30 U/L and alpha-fetoprotein levels of at least 5.0 ng/mL—were significantly associated with hepatocellular carcinoma occurrence after sustained virologic response in patients with hepatitis C virus (HCV) without advanced liver fibrosis, according to research by Yuki Tahata, MD, PhD, of Osaka University, Japan, and colleagues. The P values for these associations were strong, at .010, < .001, and .001, respectively. With these data in hand, the team created a scoring system they hope will constitute an international resource to help identify patients who need liver cancer surveillance after such a drug-induced sustained virologic response.
Their work, presented at the 2022 American Association for the Study of Liver Diseases (AASLD) Annual Meeting (Abstract 42), involved stratification of 1,682 Japanese patients with HCV who started direct-acting antiviral treatment between September 2014 and October 2020. None had advanced liver fibrosis or a history of previous hepatocellular carcinoma. All patients achieved a sustained virologic response, defined as undetectable HCV RNA at 24 weeks after the end of treatment. “Patients who experienced hepatocellular carcinoma occurrence before sustained virologic response were excluded,” noted the team.
During the median follow-up of 42.5 months from sustained virologic response, hepatocellular carcinoma was diagnosed in 28 patients, translating into cumulative hepatocellular carcinoma occurrence rates at 3 and 5 years of 1.8% and 2.5%, respectively. The researchers’ scoring system assigned 1 point for each identified risk factor—older age, higher alanine aminotransferase level, and higher alpha-fetoprotein level—and they found that no patients with a score of 0 developed hepatocellular carcinoma by the 3- or 5-year mark. “The cumulative hepatocellular carcinoma incidence rates at 3 and 5 years were 6.0% and 7.9% in patients with scores of 2 or 3, respectively,” the authors stated, indicating the potential utility of the scoring system.
Disclosure: No information regarding conflicts of interest was provided.