Aa
HCV-Associated Cirrhosis Risk Remains For HCC After SVR
"Patients With HCV-Associated Cirrhosis Remain at Risk for Developing HCC After Achieving SVR"
Source: 2013 Annual Meeting of the American Association for the Study of Liver Diseases*
Date posted: 11/6/2013
Meta-analysis of previously reported cohort studies[1]
Summary of Key Conclusions:
* Annual risk for hepatocellular carcinoma (HCC) approximately 1% in patients with HCV-induced cirrhosis who have attained SVR
* Risk increased with advanced age, more severe liver disease, and diabetes
* A population aging with chronic HCV infection and more effective antiviral regimens likely to result in an increased HCC incidence
* Authors suggest screening all cirrhotic patients who attain SVR for HCC until more risk stratification tools become available
Summary of Study Design
* Meta-analysis of individual patient data from 10 cohort studies conducted in Europe and Canada
* Eligible studies included consecutive patients chronically infected with HCV with advanced fibrosis/cirrhosis who attained SVR on interferon-based regimens
* Studies with HIV or HBV coinfection excluded
* Individual patient data excluded if developed HCC prior to start of follow-up (24 weeks post–antiviral therapy cessation)
* Kaplan-Meier analysis used to estimate cumulative HCC rates
* Differences between subgroups compared using log-rank test
Main Findings:
* 51 of 1000 patients (5.1%) developed HCC over median follow-up of 5.7 years (IQR: 2.9-8.0)
* Sex: no effect on rate of HCC (P = .474)
* Rate of HCC higher among patients with cirrhosis vs those with advanced fibrosis (P = .064)
* Older age significantly associated with greater cumulative rate of HCC in cirrhotic patients (P = .006)
HCC diagnosed in 3 patients with bridging fibrosis
* All patients had low platelet counts (≤ 166 platelets/mm3)
2 laboratory markers associated with HCC occurrence:
* Platelet count < 150,000 cells/mm3 (vs ≥ 150,000 cells/mm3) (P = .045)
* AST/ALT ratio ≥ 0.90 (P = .017)
* Factors independently associated with increased risk of developing HCC post-SVR included advanced age, low platelet count, and presence of diabetes
Hector
Source: 2013 Annual Meeting of the American Association for the Study of Liver Diseases*
Date posted: 11/6/2013
Meta-analysis of previously reported cohort studies[1]
Summary of Key Conclusions:
* Annual risk for hepatocellular carcinoma (HCC) approximately 1% in patients with HCV-induced cirrhosis who have attained SVR
* Risk increased with advanced age, more severe liver disease, and diabetes
* A population aging with chronic HCV infection and more effective antiviral regimens likely to result in an increased HCC incidence
* Authors suggest screening all cirrhotic patients who attain SVR for HCC until more risk stratification tools become available
Summary of Study Design
* Meta-analysis of individual patient data from 10 cohort studies conducted in Europe and Canada
* Eligible studies included consecutive patients chronically infected with HCV with advanced fibrosis/cirrhosis who attained SVR on interferon-based regimens
* Studies with HIV or HBV coinfection excluded
* Individual patient data excluded if developed HCC prior to start of follow-up (24 weeks post–antiviral therapy cessation)
* Kaplan-Meier analysis used to estimate cumulative HCC rates
* Differences between subgroups compared using log-rank test
Main Findings:
* 51 of 1000 patients (5.1%) developed HCC over median follow-up of 5.7 years (IQR: 2.9-8.0)
* Sex: no effect on rate of HCC (P = .474)
* Rate of HCC higher among patients with cirrhosis vs those with advanced fibrosis (P = .064)
* Older age significantly associated with greater cumulative rate of HCC in cirrhotic patients (P = .006)
HCC diagnosed in 3 patients with bridging fibrosis
* All patients had low platelet counts (≤ 166 platelets/mm3)
2 laboratory markers associated with HCC occurrence:
* Platelet count < 150,000 cells/mm3 (vs ≥ 150,000 cells/mm3) (P = .045)
* AST/ALT ratio ≥ 0.90 (P = .017)
* Factors independently associated with increased risk of developing HCC post-SVR included advanced age, low platelet count, and presence of diabetes
Hector
You ask where the 1% comes from:
The report states that the ANNUAL risk is approx. 1%.
5.1 % of patients over a 5.7 year period is indeed about a 1% annual risk.-
The report states that the ANNUAL risk is approx. 1%.
5.1 % of patients over a 5.7 year period is indeed about a 1% annual risk.-
Hi there, Hector, hope you are doing well.
Doesn't seem like anything new, but it is always good to remind ourselves that even if we are SVR, we do need to get those annual or bi-annual sonograms if we are cirrhotic. Actually I was surprised at the 1%. I thought it was a greater percentage. In fact it 5% of their surveyed patients devloped HCC. I wonder where the 1% comes from.
bean
Doesn't seem like anything new, but it is always good to remind ourselves that even if we are SVR, we do need to get those annual or bi-annual sonograms if we are cirrhotic. Actually I was surprised at the 1%. I thought it was a greater percentage. In fact it 5% of their surveyed patients devloped HCC. I wonder where the 1% comes from.
bean
Very good information and its highest rates are in African Americans I got a double whammy but I can do all things in Christ who strengthens me
Have an Answer?
You are reading content posted in the Cirrhosis of the Liver Community
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
