Advanced

A Risk for Hepatocellular Carcinoma Persists Long-term After Sustained Virologic Response in Patients With Hepatitis C-Associated Liver Cirrhosis

Aleman, Soo; Rahbin, Nogol; Weiland, Ola; Davidsdottir, Loa; Hedenstierna, Magnus; Rose, Nina; Verbaan, Hans LU ; Stal, Per; Carlsson, Tony and Norrgren, Hans LU , et al. (2013) In Clinical Infectious Diseases 57(2). p.230-236
Abstract
Background. The long-term effect of sustained virologic response (SVR) to antiviral therapy on the risk of developing hepatocellular carcinoma (HCC), liver complications, liver-related death, and overall death in hepatitis C virus (HCV)-infected patients with liver cirrhosis is not fully known. Methods. These risks were evaluated during long-term follow-up in 351 patients with HCV-related cirrhosis. One hundred ten patients with SVR, 193 with non-SVR, and 48 who were untreated were included in a multicenter cohort that was initiated in 2001 and prospectively followed up for a mean of 5.3 (SD, 2.8) years. Complementary follow-up data from national registries were used to minimize the loss of patients during follow-up. Results. Six patients... (More)
Background. The long-term effect of sustained virologic response (SVR) to antiviral therapy on the risk of developing hepatocellular carcinoma (HCC), liver complications, liver-related death, and overall death in hepatitis C virus (HCV)-infected patients with liver cirrhosis is not fully known. Methods. These risks were evaluated during long-term follow-up in 351 patients with HCV-related cirrhosis. One hundred ten patients with SVR, 193 with non-SVR, and 48 who were untreated were included in a multicenter cohort that was initiated in 2001 and prospectively followed up for a mean of 5.3 (SD, 2.8) years. Complementary follow-up data from national registries were used to minimize the loss of patients during follow-up. Results. Six patients with SVR developed HCC at 0.04, 0.64, 2.4, 7.4, 7.4, and 7.6 years, respectively, after achieving SVR. The incidences of HCC, any liver complication, liver-related death, and overall death per 100 person-years were significantly lower in SVR time with 1.0, 0.9, 0.7, and 1.9, compared to 2.3, 3.2, 3.0, and 4.1 in non-SVR and 4.0, 4.9, 4.5, and 5.1 in untreated time. The long-term consequences did not decline significantly after >3 years versus during the first 3 years of follow-up. Conclusions. The risk for HCC, liver decompensation, and death in patients with liver cirrhosis related to HCV was markedly reduced after SVR, but a long-term risk of developing HCC remains for up to 8 years. Cirrhotic patients with HCV who achieve SVR should therefore maintain long-term surveillance for HCC. Future studies aimed to better identify those with remaining long-term risk for HCC are needed. (Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
hepatocellular carcinoma, liver decompensation, liver-related death, complications, sustained virologic response
in
Clinical Infectious Diseases
volume
57
issue
2
pages
230 - 236
publisher
The Infectious Diseases Society of America
external identifiers
  • wos:000321051600011
  • scopus:84879631408
ISSN
1537-6591
DOI
10.1093/cid/cit234
language
English
LU publication?
yes
id
1d02c6a2-0c46-4b92-ba17-be8f854df49f (old id 3979534)
date added to LUP
2013-09-02 07:30:47
date last changed
2019-05-21 01:10:39
@article{1d02c6a2-0c46-4b92-ba17-be8f854df49f,
  abstract     = {Background. The long-term effect of sustained virologic response (SVR) to antiviral therapy on the risk of developing hepatocellular carcinoma (HCC), liver complications, liver-related death, and overall death in hepatitis C virus (HCV)-infected patients with liver cirrhosis is not fully known. Methods. These risks were evaluated during long-term follow-up in 351 patients with HCV-related cirrhosis. One hundred ten patients with SVR, 193 with non-SVR, and 48 who were untreated were included in a multicenter cohort that was initiated in 2001 and prospectively followed up for a mean of 5.3 (SD, 2.8) years. Complementary follow-up data from national registries were used to minimize the loss of patients during follow-up. Results. Six patients with SVR developed HCC at 0.04, 0.64, 2.4, 7.4, 7.4, and 7.6 years, respectively, after achieving SVR. The incidences of HCC, any liver complication, liver-related death, and overall death per 100 person-years were significantly lower in SVR time with 1.0, 0.9, 0.7, and 1.9, compared to 2.3, 3.2, 3.0, and 4.1 in non-SVR and 4.0, 4.9, 4.5, and 5.1 in untreated time. The long-term consequences did not decline significantly after >3 years versus during the first 3 years of follow-up. Conclusions. The risk for HCC, liver decompensation, and death in patients with liver cirrhosis related to HCV was markedly reduced after SVR, but a long-term risk of developing HCC remains for up to 8 years. Cirrhotic patients with HCV who achieve SVR should therefore maintain long-term surveillance for HCC. Future studies aimed to better identify those with remaining long-term risk for HCC are needed.},
  author       = {Aleman, Soo and Rahbin, Nogol and Weiland, Ola and Davidsdottir, Loa and Hedenstierna, Magnus and Rose, Nina and Verbaan, Hans and Stal, Per and Carlsson, Tony and Norrgren, Hans and Ekbom, Anders and Granath, Fredrik and Hultcrantz, Rolf},
  issn         = {1537-6591},
  keyword      = {hepatocellular carcinoma,liver decompensation,liver-related death,complications,sustained virologic response},
  language     = {eng},
  number       = {2},
  pages        = {230--236},
  publisher    = {The Infectious Diseases Society of America},
  series       = {Clinical Infectious Diseases},
  title        = {A Risk for Hepatocellular Carcinoma Persists Long-term After Sustained Virologic Response in Patients With Hepatitis C-Associated Liver Cirrhosis},
  url          = {http://dx.doi.org/10.1093/cid/cit234},
  volume       = {57},
  year         = {2013},
}