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J Clin Microbiol. 2018 Oct 31. pii: JCM.01463-18. doi: 10.1128/JCM.01463-18. [Epub ahead of print]

The complex association of virus- and host-related factors with HCC rate following HCV clearance.

Author information

1
Department of Hepatology, Toranomon Hospital, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan. akuta-gi@umin.ac.jp.
2
Department of Hepatology, Toranomon Hospital, and Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
3
Liver Research Laboratory, Toranomon Hospital, Tokyo, Japan.

Abstract

Little is known about the effects of virus- and host-related factors on hepatocarcinogenesis in patients who show viral clearance after HCV RNA eradication by direct-acting antivirals (DAAs). The subjects of this retrospective study were 1,922 patients with HCV genotype 1 or 2 (HCV-1 or HCV-2)-related chronic liver disease, who showed sustained virological response (SVR) (defined as negative HCV RNA at 12 weeks after cessation of all-oral DAAs). All patients were confirmed to be HCC-free before and during DAAs. HCC was diagnosed in 43 patients during the follow-up, with an incidence rate per 1,000 person years of 9.44. The cumulative HCC rates were 1.2, 2.0, and 3.1% at the end of 1, 2, and 3 years, respectively. The annual rate of HCC during the first 3 years was 1.0%. The incidence rate was significantly higher in patients infected with HCV-1b Core aa 70 Mutant than in those infected with HCV-2a/2b, and the rate in HCV-1b Core aa 70 Wild tended to be higher than in HCV-2a/2b. The rate in HCV-1b NS5A aa 93 Mutant was significantly higher than in HCV-2a/2b. However, the rate was not different between IL28B rs8099917 TT genotype and non-TT genotype. Multivariate analysis identified WFA+M2BP (cutoff index, COI, ≥2.5) and HCV Core subgroup (HCV-1b Core aa 70 Mutant), as pretreatment predictors of post-treatment HCC. The same analysis identified alpha-fetoprotein (≥5 μg/l) and WFA+M2BP (≥1.0), as predictors of HCC at 24 weeks after the end of antiviral therapy. We conclude that both viral- and host-related factors seem to influence the development of HCC after HCV RNA eradication.

PMID:
30381417
DOI:
10.1128/JCM.01463-18

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