Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with direct-acting antivirals
Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with direct-acting antivirals
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DOI：
10.1016/j.jhep.2016.06.015
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发表时间：
2016-10-01
影响因子：
25.7
通讯作者：
Brillanti, Stefano
中科院分区：
文献类型：
--
作者：
Conti, Fabio;Buonfiglioli, Federica;Brillanti, Stefano
背景与目的：肝细胞癌是丙型肝炎病毒相关性肝硬变的严重并发症。新的直接作用抗病毒药物(DAA)可治愈90%以上的患者的丙型肝炎病毒感染。本研究的目的是评估应用DAA治疗的肝硬变患者中肝细胞癌的早期发生和复发。方法：我们分析了连续344例接受DAA治疗并随访24周的无肝细胞癌的肝硬变患者。结果：DAA治疗91%的患者产生了持续的病毒学应答。在24周的随访中，26例患者(7.6%，95%CI：4.99-10.84)检出了肝细胞癌；59例既往有肝癌史的患者中有17例(28.81%，95%CI：17.76-42.07)；单因素分析显示，Child-Pugh B级、肝纤维化程度较重、血小板计数较低和既往有肝细胞癌病史与肝细胞癌的发生显著相关。经多因素分析，Child-Pugh分级(p=0.03，OR：4.18，95%CI：1.17~14.8)与肝细胞癌病史(p
Background & Aims: Hepatocellular carcinoma (HCC) represents a serious complication of HCV-related cirrhosis. New direct acting antivirals (DAA) cure HCV infection in over 90% of patients. The aim of this study was to evaluate the early occurrence and recurrence of HCC in cirrhotic patients treated with DAA.Methods: We analysed 344 consecutive cirrhotic patients, without HCC, who were treated with DAA, and followed for 24 weeks. Fifty-nine patients had previous HCC.Results: DAA therapy induced sustained virological response in 91% of patients. During 24-week follow-up, HCC was detected in 26 patients (7.6%, 95% CI: 4.99-10.84): 17 of 59 patients (28.81%, 95% CI: 17.76-42.07) with previous HCC and 9 of 285 patients (3.16%, 95% CI: 1.45-5.90) without previous HCC. Child-Pugh Class B, more severe liver fibrosis, lower platelet count, and previous HCC were significantly associated with HCC development, at univariate analysis. At multivariate analysis, Child-Pugh class (p = 0.03, OR: 4.18, 95% CI: 1.17-14.8) and history of HCC (p