Pre-Treatment Liver Stiffness Is a Stronger Predictor of Hepatocellular Carcinoma Development Than Post-Treatment Liver Stiffness After Hepatitis C Virus Eradication
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View abstract on PubMed
Summary
This summary is machine-generated.Pre-treatment liver stiffness and FIB-4 scores predict hepatocellular carcinoma (HCC) risk after hepatitis C treatment, even if they decrease post-treatment. Continued HCC surveillance is crucial for high-risk patients.
Area Of Science
- Hepatology
- Virology
- Oncology
Background
- Liver stiffness measurement (LSM) and FIB-4 levels decrease after hepatitis C virus (HCV) eradication with direct-acting antivirals (DAAs).
- The impact of these reductions on hepatocellular carcinoma (HCC) risk in patients with sustained virological response (SVR) is not fully understood.
Purpose Of The Study
- To investigate the association between pre- and post-treatment liver stiffness and FIB-4 levels and the risk of HCC development in patients who achieved SVR after DAA therapy.
- To determine if decreased LSM and FIB-4 values post-treatment correlate with a reduced HCC risk.
Main Methods
- Retrospective analysis of 501 patients with chronic hepatitis C who achieved SVR after DAA treatment.
- Measurement of LSM and FIB-4 before DAA treatment and at multiple follow-up points.
- Time-dependent Cox proportional hazards models to assess the relationship between LSM, FIB-4, and HCC development.
Main Results
- LSM and FIB-4 significantly decreased in 80.4% and 70.8% of patients, respectively, after DAA treatment.
- Higher pre-treatment LSM and FIB-4 were independent predictors of HCC development (aHRs 8.10 and 1.29, respectively).
- Post-treatment LSM and FIB-4 values showed no significant association with HCC risk; however, higher pre-treatment values indicated continued risk despite decreases.
Conclusions
- Pre-treatment LSM and FIB-4 are stronger predictors of HCC risk post-SVR than post-treatment values.
- Patients with elevated pre-treatment LSM and FIB-4 remain at increased risk for HCC, irrespective of post-treatment value reduction.
- Continued HCC surveillance is essential for patients with higher pre-treatment fibrosis markers, even after successful HCV eradication.
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