Serum α‐fetoprotein level at treatment completion is a useful predictor of hepatocellular carcinoma occurrence more than one year after hepatitis C virus eradication by direct‐acting antiviral treatment

Kuwano, Akifumi; Yada, Masayoshi; Nagasawa, Shigehiro; Tanaka, Kosuke; Morita, Yusuke; Masumoto, Akihide; Motomura, Kenta

doi:10.1111/jvh.13625

Cited by 4 publications

(4 citation statements)

References 38 publications

(89 reference statements)

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“…Serum AFP concentration has also been found to predict HCC development[ 10 , 13 ]. Higher AFP concentration is a major biomarker for HCC occurrence after SVR[ 28 , 29 ], as well as being associated with liver inflammation, making AFP concentration at the end of treatment very important[ 30 ]. AFP concentrations before and after DAA treatment should therefore be measured to estimate the risk of HCC recurrence/occurrence.…”

Section: Discussionmentioning

confidence: 99%

Direct-acting antivirals for hepatitis C virus-infected patients with hepatocellular carcinoma

Tajiri¹,

Ito²,

Kawai³

et al. 2022

WJH

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BACKGROUND Hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-infected patients has a high risk of recurrence. Although eradication of HCV is expected to reduce this risk, the risk in patients with a history of HCC may be high after treatment with direct-acting antivirals (DAAs). AIM To determine the risk factors for HCC recurrence in patients with HCV and a history of HCC. METHODS The risk of HCC recurrence in patients with a history of HCC and/or of HCC occurrence in patients without a history of HCC after DAA therapy was retrospectively analyzed in 311 HCV patients treated at our institution and several neighboring hospitals. The frequency and predictors of HCC recurrence/ occurrence after DAA treatment were included in these analyses. The clinical course of HCC before and after DAA treatment was also evaluated. RESULTS HCV patients with a history of HCC were older and had greater progression of liver fibrosis and diabetes than patients without a history of HCC. Median recurrence-free survival (RFS) was 1092 d in patients with a history of HCC, and post-DAA HCC recurrence/occurrence was observed in 29 patients (53.7%) with and 5 (1.9%) without a history of HCC over 6 years ( P < 0.001). RFS in patients with a history of HCC did not differ significantly before and after DAA treatment. The frequency of HCC recurrence/occurrence in patients with a history of HCC was lower after than before DAA treatment. Multivariate analysis showed that the incidence rate of HCC recurrence/occurrence before DAA treatment was the only independent predictor of HCC recurrence/occurrence after DAA treatment. Liver function was well preserved and clinical course was good in patients with HCC recurrence/occurrence after DAA therapy. CONCLUSION DAA therapy in patients infected with HCV is also effective in patients with a history of HCC. Curative treatment for HCC is desirable before DAA therapy. The frequency of HCC recurrence/occurrence before DAA therapy was associated with a significantly increased risk of HCC recurrence after DAA therapy. Careful observation after DAA therapy is required in patients with a history of HCC.

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Section: Discussionmentioning

confidence: 99%

Direct-acting antivirals for hepatitis C virus-infected patients with hepatocellular carcinoma

Tajiri¹,

Ito²,

Kawai³

et al. 2022

WJH

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“…Another study has focused on analysing the roles and mechanisms of zinc (Zn) in the pathogenesis of hepatitis C virus (HCV) and have reported that the oxidative stress causes a disruption in zinc (Zn) homeostasis, in particular, in the signalling molecule and secondary messenger through the redox process, resulting in HCV-mediated mitochondrial dysfunction [80]. It is worth mentioning that, upon viral eradication using interferon (IFN)-based regimens or direct-acting anti-viral (DAA) therapy, zinc (Zn) serum levels were shown to rise significantly, which reflects the hepatic inflammation's resolution as well as an improvement in the gut absorption [33].…”

Section: Zinc (Zn)mentioning

confidence: 99%

“…Zinc (Zn) serum levels were shown to rise significantly upon viral eradication using interferon (IFN)-based regimens or direct-acting anti-viral (DAA) therapy [33].…”

mentioning

confidence: 99%

The Roles and Pathogenesis Mechanisms of a Number of Micronutrients in the Prevention and/or Treatment of Chronic Hepatitis, COVID-19 and Type-2 Diabetes Mellitus

Sumaily

2022

Nutrients

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A trace element is a chemical element with a concentration (or other measures of an amount) that is very low. The essential TEs, such as copper (Cu), selenium (Se), zinc (Zn), iron (Fe) and the electrolyte magnesium (Mg) are among the most commonly studied micronutrients. Each element has been shown to play a distinctive role in human health, and TEs, such as iron (Fe), zinc (Zn) and copper (Cu), are among the essential elements required for the organisms’ well-being as they play crucial roles in several metabolic pathways where they act as enzyme co-factors, anti-inflammatory and antioxidant agents. Epidemics of infectious diseases are becoming more frequent and spread at a faster pace around the world, which has resulted in major impacts on the economy and health systems. Different trace elements have been reported to have substantial roles in the pathogenesis of viral infections. Micronutrients have been proposed in various studies as determinants of liver disorders, COVID-19 and T2DM risks. This review article sheds light on the roles and mechanisms of micronutrients in the pathogenesis and prevention of chronic hepatitis B, C and E, as well as Coronavirus-19 infection and type-2 diabetes mellitus. An update on the status of the aforementioned micronutrients in pre-clinical and clinical settings is also briefly summarized.

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“…Although HCV eradication with DAAs reduces the incidence of HCC, the unexpected early occurrence of HCC after sustained virological response (SVR) has been reported. 9 , 10 , 11 , 12 The increasing number of patients achieving HCV clearance with DAAs and the continued risk of hepatocarcinogenesis even after SVR requires the follow‐up of these patients. Loss to follow‐up (LTFU), which refers to patients who start care but voluntarily stop it, is a problem for those with chronic disease.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for loss to follow‐up after the start of direct‐acting antiviral treatment for hepatitis C virus infection

et al. 2022

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Background and Aim Direct‐acting antivirals (DAAs) have recently been developed to treat hepatitis C virus (HCV) infection. Additionally, interferon‐free DAA treatment has improved liver function and reduced the risk of hepatocellular carcinoma (HCC) following HCV eradication. Previous studies on HCV have focused mainly on the treatment rate and the risk of developing HCC, and less attention has been given to loss to follow‐up (LTFU) after DAA treatment. Therefore, the present study aimed to identify the definitive risk factors for LTFU after the start of DAA treatment. Methods Between September 2017 and March 2022, 296 patients receiving glecaprevir and pibrentasvir for HCV infection were enrolled in this study. The incidence of LTFU following DAA treatment and the risk factors contributing to LTFU were identified using the patients' clinical characteristics. Results In the present study, 75 patients (25.3%) interrupted their follow‐up visits. Multivariate logistic analysis revealed a history of injection drug use (hazard ratio [HR], 1.81; P = 0.017), treatment duration (8 weeks) (HR, 3.51; P = 0.0033), and age <70 years (HR, 1.9; P = 0.0422) as independent factors associated with LTFU after the start of DAA treatment. Conclusion Young patients and those with injection drug use are likely to discontinue their follow‐up visits after the start of DAA treatment for HCV infection. Therefore, these patients require strict supervision.

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Serum α‐fetoprotein level at treatment completion is a useful predictor of hepatocellular carcinoma occurrence more than one year after hepatitis C virus eradication by direct‐acting antiviral treatment

Cited by 4 publications

References 38 publications

Direct-acting antivirals for hepatitis C virus-infected patients with hepatocellular carcinoma

Direct-acting antivirals for hepatitis C virus-infected patients with hepatocellular carcinoma

The Roles and Pathogenesis Mechanisms of a Number of Micronutrients in the Prevention and/or Treatment of Chronic Hepatitis, COVID-19 and Type-2 Diabetes Mellitus

Risk factors for loss to follow‐up after the start of direct‐acting antiviral treatment for hepatitis C virus infection

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