In:
Alimentary Pharmacology & Therapeutics, Wiley, Vol. 54, No. 10 ( 2021-11), p. 1340-1349
Abstract:
Several factors associated with hepatocellular carcinoma (HCC) occurrence after sustained virological response (SVR) in patients with hepatitis C have been reported. However, few validation studies have been performed in the era of direct‐acting anti‐virals (DAAs). Aims To develop a prediction model for HCC occurrence after DAA‐mediated SVR and validate its usefulness. Methods We analysed 2209 patients with SVR and without a history of HCC who initiated DAA treatment at 24 Japanese hospitals. These patients were divided into a training set (1473 patients) and a validation set (736 patients). Results In the training set, multivariate Cox proportional hazards analysis showed that the baseline BMI (≥25.0 kg/m 2 , P = 0.024), baseline fibrosis‐4 (FIB‐4) index (≥3.25, P = 0.001), albumin level at SVR ( 〈 4.0 g/dL, P = 0.010) and alpha‐foetoprotein level at SVR (≥5.0 ng/mL, P = 0.006) were significantly associated with HCC occurrence. We constructed a prediction model for HCC occurrence with these four factors (2 points were added for the FIB‐4 index, and 1 point was added for each of the other three factors). Receiver operating characteristics curve analysis identified a score of 2 as the optimal cut‐off value for the prediction model (divided into 0‐1 and 2‐5). In the validation set, the sensitivity and negative predictive value for HCC occurrence were 87.5% and 99.7%, respectively, at 2 years and 71.4% and 98.0%, respectively, at 3 years. Conclusion A prediction model combining these four factors contributes to an efficient surveillance strategy for HCC occurrence after DAA‐mediated SVR.
Type of Medium:
Online Resource
ISSN:
0269-2813
,
1365-2036
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2003094-0
SSG:
15,3
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