Posttreatment nonalcoholic fatty liver disease fibrosis scores for predicting liver‐related complications in patients with chronic hepatitis C receiving direct‐acting antiviral agents

Hsu, Wei‐Fan; Lai, Hsueh‐Chou; Chuang, Po‐Heng; Su, Wen‐Pang; Chen, Sheng‐Hung; Chen, Hung‐Yao; Wang, Hung‐Wei; Huang, Guan‐Tarn; Peng, Cheng Yuan

doi:10.1111/jvh.13715

Cited by 4 publications

(5 citation statements)

References 37 publications

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“…Second, the current study had limitations related to missing follow-up data in the T-COACH and TACR databases, which led to the use of baseline information for outcome predictions. Generally, data from 12 or 24 weeks after antiviral therapy enable more accurate predictions [47]; however, the aforementioned limitations of the databases prevented us from analyzing such data. Third, although adopting a multicenter approach provides comprehensive patient data, it also introduces potential variability in normal values for laboratory tests across different hospitals.…”

Section: Discussionmentioning

confidence: 99%

The benefits of hepatitis C viral eradication: a real-world nationwide cohort study in Taiwan

Chang,

Hsu,

Tseng

et al. 2024

Preprint

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Background Chronic hepatitis C (CHC) increases the risk of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). This nationwide cohort study assessed the effectiveness of viral eradication of CHC. Methods The Taiwanese chronic hepatitis C cohort and Taiwan hepatitis C virus (HCV) registry are nationwide HCV registry cohorts incorporating data from 23 and 53 hospitals in Taiwan, respectively. This study included 27,577 individuals from these cohorts that were given a diagnosis of CHC and with data linked to the Taiwan National Health Insurance Research Database. Patients received either pegylated interferon and ribavirin or direct-acting antiviral agent therapy for > 4 weeks for new-onset LC and liver-related events. Results Among the 27,577 analyzed patients, 25,461 (92.3%) achieved sustained virologic response (SVR). The mean follow-up duration was 51.2 ± 48.4 months, totaling 118,567 person-years. In the multivariable Cox proportional hazard analysis, the hazard ratio (HR) for incident HCC was 1.39 (95% confidence interval [CI]: 1.00–1.95, p = 0.052) among noncirrhotic patients without SVR compared with those with SVR, and 1.82 (95% CI: 1.34–2.48) among cirrhotic patients without SVR. The HR for liver-related events, including HCC and decompensated LC, was 1.70 (95% CI: 1.30–2.24) among cirrhotic patients without SVR. Patients with SVR had a lower 10-year cumulative incidence of new-onset HCC than those without SVR did (21.7% versus 38.7% in patients with LC, p < 0.001; 6.0% versus 18.4% in patients without LC, p < 0.001). Conclusions HCV eradication reduced the incidence of HCC in patients with and without LC and reduced the incidence of liver-related events in patients with LC.

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Section: Discussionmentioning

confidence: 99%

The benefits of hepatitis C viral eradication: a real-world nationwide cohort study in Taiwan

Chang,

Hsu,

Tseng

et al. 2024

Preprint

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“…Noninvasive indices, such as FIB-4 score and the AST to platelet ratio index measured at the time of an SVR, were able to minimize the impact of HCV-induced hepatic necroinflammation [42]. Our previous findings indicate that noninvasive indices at PW12 had higher timedependent AUROC values than those at baseline [18]. Therefore, we used variables at PW12 to investigate the predictors of LREs and HCC.…”

Section: Discussionmentioning

confidence: 99%

“…Our previous study demonstrated that noninvasive indices at PW12 had higher time-dependent AUROC values than did those at baseline for predicting LREs [18], and the presence of hepatic necroinflammation at baseline may affect the HSI. A time-dependent AUROC was used to assess the predictive performance of each type of metabolic dysfunction.…”

Section: Metabolic Dysfunction and Fib-4 Instead Of Hepatic Steatosis...mentioning

confidence: 91%

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Effect of metabolic dysfunction on the risk of liver-related events in patients cured of hepatitis C virus

Hsu

2024

Am J Cancer Res

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The impact of metabolic dysfunction or metabolic dysfunction-associated fatty liver disease (MAFLD) on liver-related events (LREs) in patients with chronic hepatitis C (CHC) who had achieved a sustained virologic response (SVR) to direct-acting antiviral agents (DAAs) is unknown. A total of 924 patients with cured CHC and documented body mass index (BMI) were included in the analysis, and the data period was from September 2012 to April 2022. Hepatic steatosis was identified either through ultrasonography or blood biomarkers. Metabolic dysfunction was defined as the presence of overweight or obesity (BMI ≥ 23 kg/m 2 ), type 2 diabetes mellitus (DM), and metabolic dysregulation. Patients may have more than one metabolic dysfunction. Variables at 12 or 24 weeks after DAA therapy (PW12) were used to identify predictors of LREs. The median age of the 924 patients was 58 (49-65) years. Of the participants, 418 (45.2%) were male. The median BMI was 24.01 (21.78-26.73) kg/m 2 , and 174 (18.8%) patients had DM. A multivariable Cox regression analysis revealed that age, male, albumin, total bilirubin, alphafetoprotein (AFP), metabolic dysfunction (hazard ratio: 1.709, 95% confidence interval: 1.128-2.591, P = .011), and FIB-4 > 3.25 were independent predictors of LREs. Type 2 DM and metabolic dysregulation exhibited a larger time-dependent area under the receiver operating characteristic curve for LREs than did overweight or obesity. Moreover, metabolic dysfunction was identified to be an independent predictor of hepatocellular carcinoma. Metabolic dysfunction increased the risk of LREs and HCC in patients with CHC who had achieved an SVR to DAA therapy.

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“…On other hand, in patients with CHC, cirrhosis was associated with atherosclerosis independently of cardiovascular risk factors (33) . Furthermore, abnormalities in lipid metabolism and subsequent hepatic steatosis are reported to be risk factors for the progression of liver fibrosis in these patients (34,35) .…”

Section: Introductionmentioning

confidence: 99%

High-Density Lipoprotein Cholesterol and Systemic Arterial Hypertension Are Associated With Hepatic Necroinflammatory Activity in Patients With Chronic Hepatitis C

SOUZA,

SILVA,

VIEIRA

et al. 2023

Arq. Gastroenterol.

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Background: Approximately 71 million people are chronically infected with hepatitis C virus (HCV) worldwide. A significant number of these individuals will develop liver cirrhosis and/or hepatocellular carcinoma. Beyond the liver, there is a sizeable body of scientific evidence linking cardiovascular disease and chronic hepatitis C (CHC); however, the biological mechanisms behind the concurrence of these conditions have not been completely clarified yet. Objective: To evaluate associations between hepatic histology, clinical comorbidities and lipid profile in patients with CHC. To investigate associations between liver histology and demographic, nutritional, biochemical and virological parameters. Methods: Eight-five patients with CHC prospectively underwent hepatic biopsy. Liver fragments were obtained from each patient by percutaneous route using a Menghini needle. Fibrosis was evaluated according to the METAVIR scoring system, as follows: F0, no fibrosis; F1, fibrous portal expansion; F2, fibrous portal widening with few septa; F3, bridging fibrosis with architectural distortion; and F4, liver cirrhosis. The activity was classified based on the degree of lymphocyte infiltration and hepatocyte necrosis, from A0 to A3. The diagnosis of liver disease was based on clinical, biochemical, histological, and radiological methods. The data were analyzed by logistic regression models. Results: This cross-sectional study included 85 outpatients followed at the tertiary care ambulatory centre with a mean age of 57.2±10.7 years and 45 (52.9%) were females. There were 10 patients with cirrhosis. Patients with a METAVIR F3-F4 were significantly older (P=0.02) and had higher levels of ALT (P=0.0006), AST (P<0.0001), γ-GT (P=0.03) and bilirubin (P=0.001) and higher prothrombin time than patients with F0-F2 score. Albumin levels (P=0.01) were significantly lower in METAVIR F3-F4. Age (OR=1.09; 95%CI=1.02-1.16; P=0.02), steatosis (OR=4.03; 95%CI=1.05-15.45; P=0.04) and high-density lipoprotein cholesterol (HDL-C) <60 mg/dL (OR=7.67; 95%CI=1.71-34.49; P=0.008) were independently associated with fibrosis. Hypertension (OR=6.36; 95%CI=1.31-30.85; P=0.02) and HDL-C <60 mg/dL (OR=9.85; 95%CI=2.35-41.39; P=0.002) were independently associated with necroinflammatory activity. Hypertension (OR=6.94; 95%CI=1.92-25.05; P=0.003) and HDL-C <60 mg/dL (OR=3.94; 95%CI=1.27-12.3; P=0.02) were associated with interface inflammatory activity. Triglycerides (TG ≥150 mg/dL) remained associated with lobular inflammatory activity. Conclusion: cholesterol levels <60 mg/dL were independently associated with necroinflammatory activity in chronic hepatitis C. Patients with hypertension are at an increased risk of developing necroinflammatory activity.

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Posttreatment nonalcoholic fatty liver disease fibrosis scores for predicting liver‐related complications in patients with chronic hepatitis C receiving direct‐acting antiviral agents

Cited by 4 publications

References 37 publications

The benefits of hepatitis C viral eradication: a real-world nationwide cohort study in Taiwan

The benefits of hepatitis C viral eradication: a real-world nationwide cohort study in Taiwan

Effect of metabolic dysfunction on the risk of liver-related events in patients cured of hepatitis C virus

High-Density Lipoprotein Cholesterol and Systemic Arterial Hypertension Are Associated With Hepatic Necroinflammatory Activity in Patients With Chronic Hepatitis C

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