Hassan Amro M, Orabi Heba H, Abdel-Gawad Muhammad, Mohamed Omran, Sawy Safwat S, Abdelmeguid Mona M, Bashir Mohamed A, Abdelrazzak Emad, Ead Khalid, Haridy Mustafa A
Department of Hepatology, Gastroenterology, and Infectious Diseases, Al-Azhar University, Assiut, EGY.
Department of Clinical Pathology, Al-Azhar University, Assiut, EGY.
Cureus. 2024 Dec 18;16(12):e75982. doi: 10.7759/cureus.75982. eCollection 2024 Dec.
Background There is ongoing debate regarding the impact of direct-acting antiviral drugs (DAAs) on the occurrence of de novo hepatocellular carcinoma (HCC). Vascular endothelial growth factor (VEGF) plays a crucial role in the development and angiogenesis of HCC. Aim This study aims to evaluate dynamic changes in vascular endothelial growth factor (VEGF) levels at different point times during and after treatment of HCV to evaluate the risk of de novo HCC in DAAs-treated HCV patients. Methods This prospective cohort study was conducted on 60 HCV-infected patients; 30 patients had early fibrosis (F1-F2) and 30 patients had advanced fibrosis (F3-F4). HCV-RNA, aspartate aminotransferase (AST) to platelet ratio index (APRI), and fibrosis-4 index scores, liver function tests, serum VEGF, alpha-fetoprotein (AFP), and abdominal ultrasound were done at baseline, 4 weeks after starting treatment, at the end of treatment, and 12 weeks after treatment. Results VEGF was significantly decreased after completion of treatment (78.94± 10.03) compared to its baseline level (103.17 ± 33.89 pg/ml). Conclusion No de-novo hepatic focal lesion was detected during and up to 12 weeks after completion of treatment. The treatment of HCV by DAAs was associated with a significant decrease in VEGF and AFP levels and an improvement in liver enzymes and fibrosis scores.
背景 关于直接作用抗病毒药物（DAA）对初发性肝细胞癌（HCC）发生的影响，目前仍存在争议。血管内皮生长因子（VEGF）在HCC的发展和血管生成中起关键作用。目的 本研究旨在评估丙型肝炎病毒（HCV）治疗期间及治疗后不同时间点血管内皮生长因子（VEGF）水平的动态变化，以评估接受DAA治疗的HCV患者发生初发性HCC的风险。方法 本前瞻性队列研究纳入了60例HCV感染患者；30例患者为早期纤维化（F1-F2），30例患者为晚期纤维化（F3-F4）。在基线、开始治疗后4周、治疗结束时以及治疗后12周进行HCV-RNA、天冬氨酸转氨酶（AST）与血小板比值指数（APRI）、纤维化-4指数评分、肝功能检查、血清VEGF、甲胎蛋白（AFP）以及腹部超声检查。结果 与基线水平（103.17±33.89 pg/ml）相比，治疗结束后VEGF显著降低（78.94±10.03）。结论 在治疗期间及治疗结束后长达12周内均未检测到新发肝脏局灶性病变。DAA治疗HCV与VEGF和AFP水平显著降低以及肝酶和纤维化评分改善相关。
