6533b825fe1ef96bd1281e75

RESEARCH PRODUCT

Profiling the risk of hepatocellular carcinoma after long-term HCV eradication in patients with liver cirrhosis in the PITER cohort

Loreta A. KondiliMaria Giovanna QuarantaLuisa CavallettoVincenza CalvarusoLuigina FerrignoRoberta D'ambrosioIlaria SimonelliGiuseppina BrancaccioGiovanni RaimondoMaurizia R. BrunettoAnna Linda ZignegoCarmine CoppolaAndrea IannoneElisa BiliottiGabriella VerucchiMarco MassariAnna LicataFrancesco BarbaroMarcello PersicoFrancesco Paolo RussoFilomena MoriscoMaurizio PompiliMauro ViganòMassimo PuotiTeresa SantantonioErica VillaAntonio CraxìLiliana ChemelloValentina PanettaGiovanni Battista GaetaRoberto FilomiaBarbara CocoMonica MontiDaniela Caterina AmorusoSalvatore MadoniaDonatella IeluzziGloria TalianiLorenzo BadiaGuglielmo Marco MigliorinoAlessia GiorginiMario MasaronePierluigi BlancValentina CossigaMartina De SienaXhimi TataMaria Grazia RumiLuchino ChessaPietro LamperticoCarlo FerrariIvan GentileGiustino ParrutiLeonardo BaiocchiAlessia CiancioPietro InvernizziAlessandro FedericoCarlo TortiGiulia MorsicaPietro AndreoneAlessio AghemoPatrizia PopoliStefano Vella

subject

Settore MED/12Real-life cohort.HepatologyDirect-acting antiviral; HCC; Long term outcomes; Predictive factors; Real-life cohortGastroenterologyReal-life cohortLong term outcomeHCCPredictive factorDirect-acting antiviralLong term outcomesPredictive factors

description

Background and aims: Severe liver disease markers assessed before HCV eradication are acknowledged to usually improve after the SVR. We prospectively evaluated, in the PITER cohort, the long-term HCC risk profile based on predictors monitored after HCV eradication by direct-acting antivirals in patients with cirrhosis. Methods: HCC occurrence was evaluated by Kaplan-Meier analysis. Cox regression analysis identified the post-treatment variables associated with de-novo HCC; their predictive power was presented in a nomogram. Results: After the end of therapy (median follow-up:28.47 months), among 2064 SVR patients, 119 (5.8%) developed de-novo HCC. The HCC incidence was 1.90%, 4.21%, 6.47% at 12-, 24- and 36-months from end-of-therapy, respectively (incidence rate 2.45/100 person-years). Age, genotype 3, diabetes, platelets (PLT)≤120,000/µl and albumin ≤3.5g/dl levels were identified as pre-treatment HCC independent predictors. Adjusting for age, the post-treatment PLT≤120,000/µl (AdjHR 1.92; 95%CI:1.06-3.45) and albumin≤3.5g/dl (AdjHR 4.38; 95%CI 2.48-7.75) values were independently associated with HCC occurrence. Two different risk profiles were identified by combining long-term post-therapy evaluation of PLT ≤ vs. >120,000/µl and albumin ≤ vs. >3.5g/dl showing a significant different HCC incidence rate of 1.35 vs. 3.77/100 p-y, respectively. Conclusions: The nomogram score based on age, PLT and albumin levels after SVR showed an accurate prediction capability and may support the customizing management for early HCC detection.

yearjournalcountryeditionlanguage
2023-01-01
10.1016/j.dld.2023.01.153https://hdl.handle.net/2108/319297