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Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents

Calvaruso, Vincenza ; Cabibbo, Giuseppe ; Cacciola, Irene ; Petta, Salvatore ; Madonia, Salvatore ; Bellia, Alessandro ; Tinè, Fabio ; Distefano, Marco ; Licata, Anna ; Giannitrapani, Lydia ; Prestileo, Tullio ; Mazzola, Giovanni ; Di Rosolini, Maria Antonietta ; Larocca, Licia ; Bertino, Gaetano ; Digiacomo, Antonio ; Benanti, Francesco ; Guarneri, Luigi ; Averna, Alfonso ; Iacobello, Carmelo ; Magro, Antonio ; Scalisi, Ignazio ; Cartabellotta, Fabio ; Savalli, Francesca ; Barbara, Marco ; Davì, Antonio ; Russello, Maurizio ; Scifo, Gaetano ; Squadrito, Giovanni ; Cammà, Calogero ; Raimondo, Giovanni ; Craxì, Antonio ; Di Marco, Vito ; Craxì, A. ; Di Marco, V. ; Cammà, C. ; Calvaruso, V. ; Petta, S. ; Cabbibbo, G. ; Colletti, P. ; Mazzola, G. ; Cascio, A. ; Montalto, G. ; Licata, A. ; Giannitrapani, L. ; Prestileo, T. ; Di Lorenzo, F. ; Sanfilippo, A. ; Ficalora, A. ; Madonia, S. ; Tinè, F. ; Malizia, G. ; Latteri, F. ; Maida, M. ; Cartabellotta, F. ; Vassallo, R. ; Cacciola, I. ; Caccamo, G. ; Maimone, S. ; Saitta, C. ; Squadrito, G. ; Raimondo, G. ; Mondello, L. ; Smedile, A. ; D’Andrea, S. ; Bertino, G. ; Ardiri, A.L. ; Frazzetto, E. ; Rigano, G. ; Montineri, A. ; Larocca, L.N. ; Cacopardo, B. ; Benanti, F. ; Russello, M. ; Benigno, R. ; Bellia, A. ; Iacobello, C. ; Davì, A. ; Di Rosolini, M.A. ; Digiacomo, A. ; Fuduli, G. ; Scifo, G. ; Distefano, M. ; Portelli, V. ; Savalli, F. ; Scalici, I. ; Gioia, G. ; Magro, A. ; Alaimo, G. ; Alinovi, M.R. ; Salvo, A. ; Averna, A. ; Lomonaco, F. ; Guarneri, L. ; Maffeo, F. ; Falzone, E. ; Pulvirenti, F.

Gastroenterology (New York, N.Y. 1943), 2018-08, Vol.155 (2), p.411-421.e4 [Periódico revisado por pares]

United States: Elsevier Inc

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Título:
Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents
Autor: Calvaruso, Vincenza ; Cabibbo, Giuseppe ; Cacciola, Irene ; Petta, Salvatore ; Madonia, Salvatore ; Bellia, Alessandro ; Tinè, Fabio ; Distefano, Marco ; Licata, Anna ; Giannitrapani, Lydia ; Prestileo, Tullio ; Mazzola, Giovanni ; Di Rosolini, Maria Antonietta ; Larocca, Licia ; Bertino, Gaetano ; Digiacomo, Antonio ; Benanti, Francesco ; Guarneri, Luigi ; Averna, Alfonso ; Iacobello, Carmelo ; Magro, Antonio ; Scalisi, Ignazio ; Cartabellotta, Fabio ; Savalli, Francesca ; Barbara, Marco ; Davì, Antonio ; Russello, Maurizio ; Scifo, Gaetano ; Squadrito, Giovanni ; Cammà, Calogero ; Raimondo, Giovanni ; Craxì, Antonio ; Di Marco, Vito ; Craxì, A. ; Di Marco, V. ; Cammà, C. ; Calvaruso, V. ; Petta, S. ; Cabbibbo, G. ; Colletti, P. ; Mazzola, G. ; Cascio, A. ; Montalto, G. ; Licata, A. ; Giannitrapani, L. ; Prestileo, T. ; Di Lorenzo, F. ; Sanfilippo, A. ; Ficalora, A. ; Madonia, S. ; Tinè, F. ; Malizia, G. ; Latteri, F. ; Maida, M. ; Cartabellotta, F. ; Vassallo, R. ; Cacciola, I. ; Caccamo, G. ; Maimone, S. ; Saitta, C. ; Squadrito, G. ; Raimondo, G. ; Mondello, L. ; Smedile, A. ; D’Andrea, S. ; Bertino, G. ; Ardiri, A.L. ; Frazzetto, E. ; Rigano, G. ; Montineri, A. ; Larocca, L.N. ; Cacopardo, B. ; Benanti, F. ; Russello, M. ; Benigno, R. ; Bellia, A. ; Iacobello, C. ; Davì, A. ; Di Rosolini, M.A. ; Digiacomo, A. ; Fuduli, G. ; Scifo, G. ; Distefano, M. ; Portelli, V. ; Savalli, F. ; Scalici, I. ; Gioia, G. ; Magro, A. ; Alaimo, G. ; Alinovi, M.R. ; Salvo, A. ; Averna, A. ; Lomonaco, F. ; Guarneri, L. ; Maffeo, F. ; Falzone, E. ; Pulvirenti, F.
Assuntos: Aged ; Antiviral Agents - therapeutic use ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - virology ; Female ; Follow-Up Studies ; Hepacivirus - drug effects ; Hepacivirus - isolation & purification ; Hepatitis C, Chronic - drug therapy ; Hepatitis C, Chronic - virology ; Humans ; Incidence ; Italy - epidemiology ; Liver Cancer Risk ; Liver Cirrhosis - drug therapy ; Liver Cirrhosis - virology ; Liver Neoplasms - epidemiology ; Liver Neoplasms - virology ; Male ; Middle Aged ; Prospective Studies ; Reduction ; RESIST-HCV ; Risk Factors ; Sofosbuvir ; Sustained Virologic Response
É parte de: Gastroenterology (New York, N.Y. 1943), 2018-08, Vol.155 (2), p.411-421.e4
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Studies have produced conflicting results of the incidence of hepatocellular carcinoma (HCC) in patients with hepatitis C virus–associated cirrhosis treated with direct-acting antivirals (DAAs). Data from clinics are needed to accurately assess the occurrence rate of HCC in patients with cirrhosis in the real world. We collected data from a large prospective study of 2,249 consecutive patients (mean age = 65.4 years, 56.9% male) with hepatitis C virus–associated cirrhosis (90.5% with Child-Pugh class A and 9.5% with Child-Pugh class B) treated with DAAs from March 2015 through July 2016 at 22 academic and community liver centers in Sicily, Italy. HCC occurrence was evaluated by Kaplan-Meier curves. Cox regression analysis was used to identify variables associated with HCC development. A sustained virologic response (SVR) was achieved by 2,140 patients (total = 95.2%; 95.9% with Child Pugh class A and 88.3% with Child Pugh class B; P < .001). Seventy-eight patients (3.5%) developed HCC during a mean follow-up of 14 months (range = 6–24 months). At 1 year after exposure to DAAs, HCC developed in 2.1% of patients with Child-Pugh class A with an SVR and 6.6% of patients with no SVR and in 7.8% of patients with Child-Pugh class B with an SVR and 12.4% of patients with no SVR (P < .001 by log-rank test). Albumin level below 3.5 g/dL (hazard ratio = 1.77, 95% confidence interval = 1.12–2.82, P = .015), platelet count below 120 × 109/L (hazard ratio = 3.89, 95% confidence interval = 2.11–7.15, P < .001), and absence of an SVR (hazard ratio = 3.40, 95% confidence interval = 1.89–6.12, P < .001) were independently associated increased risk for HCC. The mean interval from exposure to DAAs to an HCC diagnosis was 9.8 months (range = 2–22 months) and did not differ significantly between patients with (n = 64, 9.2 months) and without (n = 14, 12.0 months) an SVR (P = .11). A larger proportion of patients with an SVR had a single HCC lesion (78% vs 50% without an SVR; P = .009) or an HCC lesion smaller than 3 cm (58% vs 28% without an SVR; P = .07). In an analysis of data from a large prospective study of patients with hepatitis C virus–associated compensated or decompensated cirrhosis, we found that the SVR to DAA treatment decreased the incidence of HCC over a mean follow-up of 14 months.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Incidence of Hepatocellular Carcinoma in Patients With HCV-Associated Cirrhosis Treated With Direct-Acting Antiviral Agents

United States: Elsevier Inc

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