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Risk Factors for Liver Decompensation and HCC in HCV-Cirrhotic Patients after DAAs: A Multicenter Prospective Study
- Source :
- Cancers, Vol 13, Iss 3810, p 3810 (2021), Cancers, Volume 13, Issue 15
- Publication Year :
- 2021
-
Abstract
- 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 &lt<br />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<br />95% CI 1.1–14.1) and genotype different from 1 (HR 7.5<br />95% CI 2.1–27.3) were both independent predictors of liver decompensation. Baseline LSM &gt<br />20 KPa (HR 7.2<br />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 :
- 0301 basic medicine
Cancer Research
medicine.medical_specialty
Cirrhosis
Independent predictor
Gastroenterology
Article
03 medical and health sciences
0302 clinical medicine
Liver stiffness
Internal medicine
Medicine
Liver decompensation
HCC
Prospective cohort study
RC254-282
DAA
liver decompensation
business.industry
Proportional hazards model
cirrhosis
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
virus diseases
DAAs
medicine.disease
digestive system diseases
liver stiffness
030104 developmental biology
Oncology
HCV
030211 gastroenterology & hepatology
business
cirrhosi
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Cancers, Vol 13, Iss 3810, p 3810 (2021), Cancers, Volume 13, Issue 15
- Accession number :
- edsair.doi.dedup.....8a4d1593daaecc52fec351e436ca9f0b