Metabolic management after sustained virologic response in elderly patients with hepatitis C virus : A multicenter study
© 2023 Japan Society of Hepatology..
AIMS: Hepatocellular carcinoma (HCC) develops even in patients with hepatitis C virus (HCV) eradication by direct-acting antiviral agents. Fatty liver and metabolic dysfunction are becoming major etiologies of HCC. We aimed to evaluate the impact of metabolic dysfunction-associated steatotic liver disease (MASLD), a new definition of steatotic liver disease, on the development of HCC after HCV eradication.
METHODS: We enrolled 1280 elderly patients with HCV eradication and no history of HCC. We evaluated α-fetoprotein (AFP), Fibrosis-4 index and MASLD after 24 weeks of sustained virological response. Decision tree analysis was used to investigate factors associated with HCC development after HCV eradication.
RESULTS: A total of 86 patients (6.7%) developed HCC during the follow-up period (35.8 ± 23.7 months). On multivariate analysis, serum AFP level (HR 1.08, CI 1.04-1.11, P = 0.0008), Fibrosis-4 index (HR 1.17, CI 1.08-1.26, P = 0.0007), and MASLD (HR 3.04, CI 1.40-6.58, P = 0.0125) at 24 weeks of sustained virological response were independent factors associated with HCC development. In decision tree analysis, the initial classifier for HCC development was AFP ≥7 ng/mL. However, in patients with AFP <7 ng/mL, MASLD, rather than Fibrosis-4 index, was the classifier for HCC development. No significant difference was observed in the cumulative incidence of HCC between patients with AFP ≥7 ng/mL and patients with AFP <7 ng/mL and MASLD.
CONCLUSION: MASLD at 24 weeks of sustained virological response is a risk factor for HCC development in elderly patients with HCV eradication. Additionally, decision tree analysis revealed that MASLD was associated with HCC development, even in patients with serum AFP levels <7 ng/mL.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
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| Enthalten in: |
Hepatology research : the official journal of the Japan Society of Hepatology - 54(2024), 4 vom: 02. Apr., Seite 326-335 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sano, Tomoya [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 02.04.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1111/hepr.13993 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364668342 |
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| 100 | 1 | |a Sano, Tomoya |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Metabolic management after sustained virologic response in elderly patients with hepatitis C virus |b A multicenter study |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 02.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 Japan Society of Hepatology. | ||
| 520 | |a AIMS: Hepatocellular carcinoma (HCC) develops even in patients with hepatitis C virus (HCV) eradication by direct-acting antiviral agents. Fatty liver and metabolic dysfunction are becoming major etiologies of HCC. We aimed to evaluate the impact of metabolic dysfunction-associated steatotic liver disease (MASLD), a new definition of steatotic liver disease, on the development of HCC after HCV eradication | ||
| 520 | |a METHODS: We enrolled 1280 elderly patients with HCV eradication and no history of HCC. We evaluated α-fetoprotein (AFP), Fibrosis-4 index and MASLD after 24 weeks of sustained virological response. Decision tree analysis was used to investigate factors associated with HCC development after HCV eradication | ||
| 520 | |a RESULTS: A total of 86 patients (6.7%) developed HCC during the follow-up period (35.8 ± 23.7 months). On multivariate analysis, serum AFP level (HR 1.08, CI 1.04-1.11, P = 0.0008), Fibrosis-4 index (HR 1.17, CI 1.08-1.26, P = 0.0007), and MASLD (HR 3.04, CI 1.40-6.58, P = 0.0125) at 24 weeks of sustained virological response were independent factors associated with HCC development. In decision tree analysis, the initial classifier for HCC development was AFP ≥7 ng/mL. However, in patients with AFP <7 ng/mL, MASLD, rather than Fibrosis-4 index, was the classifier for HCC development. No significant difference was observed in the cumulative incidence of HCC between patients with AFP ≥7 ng/mL and patients with AFP <7 ng/mL and MASLD | ||
| 520 | |a CONCLUSION: MASLD at 24 weeks of sustained virological response is a risk factor for HCC development in elderly patients with HCV eradication. Additionally, decision tree analysis revealed that MASLD was associated with HCC development, even in patients with serum AFP levels <7 ng/mL | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a alpha‐fetoproteins | |
| 650 | 4 | |a direct‐acting antiviral agents | |
| 650 | 4 | |a fatty liver | |
| 650 | 4 | |a fibrosis‐4 index | |
| 650 | 4 | |a hepatocellular carcinoma | |
| 650 | 4 | |a liver fibrosis | |
| 650 | 4 | |a metabolic dysfunction associated fatty liver disease | |
| 650 | 4 | |a metabolic dysfunction‐associated steatotic liver disease | |
| 700 | 1 | |a Amano, Keisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Ide, Tatsuya |e verfasserin |4 aut | |
| 700 | 1 | |a Isoda, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Honma, Yuichi |e verfasserin |4 aut | |
| 700 | 1 | |a Morita, Yasuyo |e verfasserin |4 aut | |
| 700 | 1 | |a Yano, Yoichi |e verfasserin |4 aut | |
| 700 | 1 | |a Nakamura, Hiroki |e verfasserin |4 aut | |
| 700 | 1 | |a Itano, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Miyajima, Ichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Shirachi, Miki |e verfasserin |4 aut | |
| 700 | 1 | |a Kuwahara, Reiichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Ohno, Miki |e verfasserin |4 aut | |
| 700 | 1 | |a Kawaguchi, Toshihiro |e verfasserin |4 aut | |
| 700 | 1 | |a Tsutsumi, Tsubasa |e verfasserin |4 aut | |
| 700 | 1 | |a Nakano, Dan |e verfasserin |4 aut | |
| 700 | 1 | |a Arinaga-Hino, Teruko |e verfasserin |4 aut | |
| 700 | 1 | |a Kawaguchi, Machiko |e verfasserin |4 aut | |
| 700 | 1 | |a Eguchi, Yuichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Torimura, Takuji |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Hirokazu |e verfasserin |4 aut | |
| 700 | 1 | |a Harada, Masaru |e verfasserin |4 aut | |
| 700 | 1 | |a Kawaguchi, Takumi |e verfasserin |4 aut | |
| 700 | 0 | |a SAKS Study Group |e verfasserin |4 aut | |
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