High incidence of hepatocarcinoma in patients with advanced fibrosis treated with direct-acting antiviral agents for hepatitis C: A real-world retrospective study - 29/06/24
, Rui Gaspar a, b, Lurdes Santos a, c, Guilherme Macedo a, bHighlights |
• | High incidence of hepatocarcinoma in patients treated with direct-acting antivirals. |
• | Arterial hypertension stands as a risk factor for hepatocarcinoma. |
• | Alcohol use before hepatitis C treatment increases the risk of liver decompensation. |
• | Portal hypertension signs are associated with hepatocarcinoma and decompensation. |
Abstract |
Background |
Patients treated with direct-acting antivirals for hepatitis C exhibit high cure rates and improved survival. However, there is limited knowledge on their long-term clinical evolution.
Aims |
In this study, we aimed to analyse the risk of hepatocarcinoma and hepatic decompensation in patients treated with direct-acting antivirals.
Methods |
We conducted a retrospective single-centre study of Portuguese patients with advanced fibrosis treated with direct-acting antiviral agents between 2015 and 2022 at a tertiary hospital.
Results |
Out of 460 patients, 50 (10.9 %) developed hepatocarcinoma and 36 (7.8 %) experienced hepatic decompensation. The risk for hepatocarcinoma was higher in patients aged over 55 (HR 4.87, 95 % CI 2.34–10.13, p < 0.001), with signs of portal hypertension (HR 3.83, 95 % CI 2.05–7.13, p < 0.001) and arterial hypertension (HR 1.98, 95 % CI 1.09–3.58, p = 0.024). Alcohol consumption (HR 3.30, 95 % CI 1.22–8.94, p = 0.019), signs of portal hypertension (HR 4.56, 95 % CI 2.19–9.48, p < 0.001) and hepatocarcinoma (HR 3.47, 95 % CI 1.69–7.10, p < 0.001) increased the risk of hepatic decompensation.
Conclusion |
Our study found a high incidence of hepatocarcinoma and hepatic decompensation, along with high mortality, in patients with advanced fibrosis treated with direct-acting antivirals. We identified risk factors such as arterial hypertension, alcohol consumption, and signs of portal hypertension, highlighting their role in clinical management and patient monitoring.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Hepatocarcinoma, Hepatic decompensation, Risk factors
Abbreviations : HCC, DAA, SVR, MELD, HVPG
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Vol 48 - N° 7
Articolo 102404- Agosto 2024 Ritorno al numero
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