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Impact of the introduction of direct-acting anti-viral drugs on hepatocarcinogenesis: a prospective serial follow-up MRI study.
- Source :
-
Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2020 Jul; Vol. 52 (2), pp. 359-370. Date of Electronic Publication: 2020 Jun 10. - Publication Year :
- 2020
-
Abstract
- Background: We conducted a prospective study using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI) to determine whether sustained virological response (SVR) by direct-acting anti-viral (DAA) drugs suppresses hepatocarcinogenesis in patients with hepatitis C virus (HCV) infection.<br />Aim: To use serial Gd-EOB-MRI to assess the impact of DAAs on hepatocarcinogenesis.<br />Methods: Between February 2008 and December 2018, 1083 consecutive patients with HCV infection underwent Gd-EOB-MRI. Of these, 719 patients were enrolled, including 210 patients in the 'Non-DAA group', who did not receive DAAs before the introduction of DAAs, and 509 patients in the 'DAA group', who achieved SVR after the introduction of DDAs. Factors associated with hepatocarcinogenesis were analysed by a Cox proportional hazard model. In addition, hepatocarcinogenesis was classified into two types, 'multistep' and 'de novo', on the basis of Gd-EOB-MRI findings. Factors associated with each type were analysed by Fine and Gray proportional hazards models.<br />Results: Hepatocarcinogenesis was observed in 67 of 719 (9.3%) patients. Factors associated with hepatocarcinogenesis were male gender, albumin-bilirubin (ALBI) grade 2 or 3, Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein (AFP-L3) ≥5%, the presence of nonhypervascular hypointense nodules (NHHNs) and Non-DAA group. Of 67 patients, multistep hepatocarcinogenesis occurred in 58 patients (86.6%) and de novo hepatocarcinogenesis occurred in nine patients (13.4%). Factors associated with multistep hepatocarcinogenesis were male gender and Non-DAA group.<br />Conclusion: The eradication of HCV by DAA therapy reduces multistep hepatocarcinogenesis.<br /> (© 2020 John Wiley & Sons Ltd.)
- Subjects :
- Aged
Bilirubin blood
Carcinoma, Hepatocellular diagnostic imaging
Carcinoma, Hepatocellular virology
Contrast Media
Female
Follow-Up Studies
Gadolinium DTPA
Hepatitis C diagnostic imaging
Hepatitis C virology
Humans
Liver Neoplasms diagnostic imaging
Liver Neoplasms virology
Magnetic Resonance Imaging
Male
Middle Aged
Prospective Studies
Serum Albumin analysis
Sex Characteristics
Sustained Virologic Response
alpha-Fetoproteins analysis
Antiviral Agents therapeutic use
Carcinoma, Hepatocellular drug therapy
Carcinoma, Hepatocellular etiology
Hepatitis C complications
Hepatitis C drug therapy
Liver Neoplasms drug therapy
Liver Neoplasms etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2036
- Volume :
- 52
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Alimentary pharmacology & therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 32519782
- Full Text :
- https://doi.org/10.1111/apt.15825