Premium
Association between steatohepatitis biomarkers and hepatocellular carcinoma after hepatitis C elimination
Author(s) -
Ogawa Eiichi,
Takayama Koji,
Hiramine Satoshi,
Hayashi Takeo,
Toyoda Kazuhiro
Publication year - 2020
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15976
Subject(s) - medicine , hepatocellular carcinoma , steatohepatitis , gastroenterology , hazard ratio , proportional hazards model , hepatitis c , cumulative incidence , cirrhosis , hepatitis c virus , steatosis , fatty liver , biomarker , cohort , confidence interval , immunology , disease , virus , biochemistry , chemistry
Summary Background A strong association between chronic hepatitis C (CHC) and hepatic steatosis has been reported. However, the influence of steatohepatitis on hepatocellular carcinoma (HCC) after hepatitis C virus (HCV) elimination remains unclear. Aim To evaluate the development of HCC after HCV cure using a new steatohepatitis‐related biomarker. Methods This cohort study analysed the prospective database of 290 CHC patients without a history of HCC who achieved HCV elimination by direct‐acting antivirals. We calculated the FibroScan‐aspartate aminotransferase (FAST) score 12 weeks after the end of treatment (pw12). The risk of HCC was analysed using the multivariable Cox proportional hazard model. Results HCV genotype (GT)1 was most prevalent at 72.4%, followed by GT2 (26.6%). Median follow‐up period was 4.2 years (IQR 3.1‐4.5). The cumulative HCC incidence for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35 (log‐rank test: P < 0.001). The annual HCC incidence rate for a FAST score ≥ 0.35 was significantly higher than that for a FAST score < 0.35, in patients with liver stiffness measurement (LSM) ≥10 kPa (adjusted hazard ratio [HR] 4.41, 95% confidence interval [CI] 1.30‐15.0, P = 0.018). After adjusting for variables, including age, albumin, alpha‐fetoprotein, the patatin‐like phospholipase domain‐containing the 3 (PNPLA3) rs738409 genotype, and pw12 fibrosis markers with FIB‐4, non‐alcoholic fatty liver disease fibrosis score, and LSM, FAST score ≥ 0.35 was associated with the development of HCC (adjusted HR 4.42, 95% CI 1.02‐19.9, P = 0.043). Conclusions Steatohepatitis‐related biomarkers with the FAST score are helpful for predicting the development of HCC after HCV elimination.