We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Dynamic α-fetoprotein, platelets and AST-to-platelet ratio index predict hepatocellular carcinoma in chronic hepatitis C patients with sustained virological response after antiviral therapy.
- Authors
Cheng-Kun Wu; Kuo-Chin Chang; Chao-Hung Hung; Po-Lin Tseng; Sheng-Nan Lu; Chien-Hung Chen; Jing-Houng Wang; Chuan-Mo Lee; Ming-Chao Tsai; Ming-Tsung Lin; Yi-Hao Yen; Tsung-Hui Hu; Wu, Cheng-Kun; Chang, Kuo-Chin; Hung, Chao-Hung; Tseng, Po-Lin; Lu, Sheng-Nan; Chen, Chien-Hung; Wang, Jing-Houng; Lee, Chuan-Mo
- Abstract
<bold>Background: </bold>Hepatitis C virus (HCV)-infected patients who achieve viral eradication may still develop hepatocellular carcinoma (HCC). Little is known about the impact of dynamic change of serum markers on HCC development.<bold>Methods: </bold>We enrolled 1351 HCV-infected patients who achieved sustained virological response (SVR). Laboratory data were collected at least 1 year after IFN-based therapy and to the latest follow-up. Data on α-fetoprotein (AFP) were obtained >6 months prior to HCC development to exclude HCC-related AFP elevation.<bold>Results: </bold>HCC developed in 49 patients. Risk factors for HCC in SVR patients were old age, liver cirrhosis, higher pre- and post-treatment AFP and high post-treatment AST-to-platelet ratio index (APRI). Patients with pre-AFP ≥15 ng/mL → post-AFP ≥15 ng/mL (at 1 year, 23.1%; 5 years, 42.3%) and pre-AFP <15 ng/mL → post-AFP ≥15 ng/mL (at 1 year, 25%; 5 years, 50%) had the highest risk of HCC development, followed by pre-AFP ≥15 ng/mL → post-AFP <15 ng/mL (at 1 year, 5.2%; 5 years, 7.6%) and pre-AFP <15 ng/mL → post-AFP ng/mL <15 ng/mL (at 1 year, 0.5%; 5 years, 0.9%) (P < 0.001). The pattern was similar for platelets and APRI (P < 0.001). SVR patients with pre-APRI ≥0.7 → post-APRI ≥0.7 had the highest risk of HCC development, followed by comparable risks among the other three groups.<bold>Conclusions: </bold>SVR patients with a persistently high AFP level (≥15 ng/mL) and a high APRI (≥0.7) before and after treatment had the highest incidence of HCC development. Patients with a reduction of AFP and APRI to the normal range after treatment had a markedly decreased risk of HCC. The risk was lowest for patients who kept persistently normal AFP and APRI before and after treatment.
- Subjects
ALPHA fetoproteins; LIVER cancer; CHRONIC hepatitis C; INTERFERONS; CIRRHOSIS of the liver; ANTIVIRAL agents; ASPARTATE aminotransferase; COMPARATIVE studies; HEPATOCELLULAR carcinoma; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RESEARCH; EVALUATION research; DISEASE incidence; PLATELET count; DISEASE complications; DIAGNOSIS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2016, Vol 71, Issue 7, p1943
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkw097