We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Risk Factors for Liver Decompensation and HCC in HCV-Cirrhotic Patients after DAAs: A Multicenter Prospective Study.
- Authors
Morisco, Filomena; Federico, Alessandro; Marignani, Massimo; Cannavò, Mariarita; Pontillo, Giuseppina; Guarino, Maria; Dallio, Marcello; Begini, Paola; Benigno, Rosa G.; Lombardo, Flavia L.; Stroffolini, Tommaso
- Abstract
Simple Summary: The present study explored the predictors of the development of liver-related events in HCV cirrhotic subjects achieving SVR following antiviral therapy with direct-acting antiviral agents (DAAs) during a follow-up of 24 months after SVR confirmation. Patients had a liver stiffness measurement (LSM) of ≥14 kPa at baseline. We found that baseline liver stiffness ≥ 20 kPa and HCV genotype different from 1 were both independent predictors of liver decompensation, while only LSM ≥ 20 kPa was an independent predictor of HCC. Background: Prospective studies on predictors of liver-related events in cirrhotic subjects achieving SVR after DAAs are lacking. Methods: We prospectively enrolled HCV cirrhotic patients in four Italian centers between November 2015 and October 2017. SVR and no-SVR cases were compared according to the presence or absence of liver-related events during a 24-month follow-up. Independent predictors of liver-related events were evaluated by Cox regression analysis. Results: A total of 706 subjects started DAAs therapy. SVR was confirmed in 687 (97.3%). A total of 61 subjects (8.9%) in the SVR group and 5 (26.3%) in the no-SVR group had liver-related events (p < 0.03). The incidence rate x 100 p/y was 1.6 for HCC, 1.7 for any liver decompensation, and 0.5 for hepatic death. Baseline liver stiffness (LSM) ≥ 20 kPa (HR 4.0; 95% CI 1.1–14.1) and genotype different from 1 (HR 7.5; 95% CI 2.1–27.3) were both independent predictors of liver decompensation. Baseline LSM > 20 KPa (HR 7.2; 95% CI 1.9–26.7) was the sole independent predictor of HCC. A decrease in liver stiffness (Delta LSM) by at least 20% at the end of follow-up was not associated with a decreased risk of liver-related events. Conclusion: Baseline LSM ≥ 20 kPa identifies HCV cirrhotic subjects at higher risk of liver-related events after SVR.
- Subjects
STATISTICS; RESEARCH; CHRONIC hepatitis C; CONFIDENCE intervals; MULTIVARIATE analysis; LOG-rank test; CIRRHOSIS of the liver; MEDICAL cooperation; LIVER diseases; RISK assessment; DESCRIPTIVE statistics; GENOTYPES; KAPLAN-Meier estimator; DATA analysis software; HEPATOCELLULAR carcinoma; LONGITUDINAL method; DISEASE risk factors; DISEASE complications
- Publication
Cancers, 2021, Vol 13, Issue 15, p3810
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers13153810