Rasool Shahid, Hanif Sofia, Ahmad Aneeqa, Shafqat Umair, Babar Ahmad Nawaz
Department of Gastroenterology, University Medical and Dental College, Faisalabad, Punjab, Pakistan.
Department of Gastroenterology, Madina Teaching Hospital, Faisalabad, Punjab, Pakistan.
Euroasian J Hepatogastroenterol. 2022 Jul-Dec;12(2):73-76. doi: 10.5005/jp-journals-10018-1383.
Chronic hepatitis C (CHC) management has changed tremendously after direct-acting antivirals (DAAs) availability. Sustained virological response (SVR) has improved significantly, but one of the major concerns is the chances of hepatocellular carcinoma (HCC) development after DAAs. The objective of the study is to calculate the frequency of newly diagnosed cases of HCC after antiviral therapy for CHC in Pakistan.
This prospective, interventional research was conducted from June 2017 to September 2020. All patients after antiviral therapy for CHC were followed with an ultrasound abdomen and α-fetoprotein, six monthly. Multiphasic computed tomography (CT) of the abdomen was performed in suspected cases. For quantitative variables, the mean and standard deviations were calculated, whereas the qualitative variables were analyzed by frequencies and percentages.
Among 180 patients, 110 were men and 70 were women with a mean age of 45.52 ± 11.71 years. One hundred and twenty-six patients were noncirrhotic, 38 had compensated cirrhosis while 16 had decompensated cirrhosis. One hundred and sixty-four (91.11%) patients achieved SVR, of which 22 (12.22%) patients developed new HCC during follow-up. Compensated cirrhosis group had 10 patients, the decompensated group had 12 patients, and the noncirrhotic group had no new HCC cases. Among patients with the new HCC, 12 achieved SVR.
The risk of the development of HCC after antiviral treatment is highly significant among patients with liver cirrhosis. So, a strict surveillance strategy should be adopted in every cirrhotic patient following treatment with DAA agents even if they achieve SVR.
Chances of developing HCC are still significantly high even after achieving SVR with DAAs in patients with liver cirrhosis.Patients with liver cirrhosis should be under surveillance for HCC even after achieving SVR after DAAs treatment.
Rasool S, Hanif S, Ahmad A, . Frequency of Hepatocellular Carcinoma after Direct-acting Antiviral Therapy for Chronic Hepatitis C: A Prospective Follow-up. Euroasian J Hepato-Gastroenterol 2022;12(2):73-76.
直接抗病毒药物（DAAs）问世后，慢性丙型肝炎（CHC）的治疗发生了巨大变化。持续病毒学应答（SVR）显著改善，但主要担忧之一是DAAs治疗后肝细胞癌（HCC）发生的可能性。本研究的目的是计算巴基斯坦CHC抗病毒治疗后新诊断HCC病例的发生率。
本前瞻性干预研究于2017年6月至2020年9月进行。所有CHC抗病毒治疗后的患者每6个月接受一次腹部超声和甲胎蛋白检查。疑似病例进行腹部多期计算机断层扫描（CT）。对于定量变量，计算均值和标准差，而定性变量通过频率和百分比进行分析。
180例患者中，男性110例，女性70例，平均年龄45.52±11.71岁。126例患者无肝硬化，38例有代偿期肝硬化，16例有失代偿期肝硬化。164例（91.11%）患者实现了SVR，其中22例（12.22%）患者在随访期间发生了新的HCC。代偿期肝硬化组有10例患者，失代偿期组有12例患者，无肝硬化组无新的HCC病例。在新发HCC的患者中，12例实现了SVR。
肝硬化患者抗病毒治疗后发生HCC的风险非常高。因此，即使肝硬化患者在接受DAA药物治疗后实现了SVR，也应在治疗后对每例患者采取严格的监测策略。
即使肝硬化患者使用DAAs实现SVR后，发生HCC的可能性仍然显著较高。肝硬化患者在DAAs治疗实现SVR后仍应接受HCC监测。
Rasool S, Hanif S, Ahmad A, . 慢性丙型肝炎直接抗病毒治疗后肝细胞癌的发生率：一项前瞻性随访研究。《欧亚肝脏胃肠病学杂志》2022；12(2):73 - 76。
