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Prediction of the very early occurrence of HCC right after DAA therapy for HCV infection

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Abstract

Background

Although direct-acting antiviral (DAA) developments make most of hepatitis C virus (HCV) infection curable, some HCV patients develop hepatocellular carcinoma (HCC) after curative treatment of HCV. There is much dispute whether the rapid clearance of the virus enhances the HCC development. In advance of the dispute, we should make clear the characteristics of the patients with very early occurrence and recurrence of HCC after DAA therapy because it was still unclear.

Methods

We prospectively followed consecutive patients with HCV who had received sofosbuvir (SOF)-based treatment at two hospitals. The baseline characteristics, laboratory data, and liver imaging findings were acquired. We evaluated the rate of HCC occurrence and recurrence within 1-year after DAA therapy and analyzed the associated factors of very early HCC occurrence and recurrence right after SOF therapy.

Results

Between July 2013 and October 2016, we studied two cohorts with HCV infection that received SOF therapy. 402 and 462 patients in Yamanashi Central Hospital and Chiba University Hospital were included in this analysis, respectively. The SVR12 rates of genotypes 1 and 2 were 98.9% (561/567) and 96.0% (285/297), respectively. 41 patients developed HCC within 1 year after SOF therapy. The cumulative HCC occurrence and recurrence rate after SOF therapy was 5.0%. The common associated factor of 1-year HCC occurrence and recurrence in all cohorts was the existence of imaging “dysplastic nodule”.

Conclusions

SOF regimens for HCV also have very high rates of SVR 12 in the post-market distribution. The appearance of imaging “dysplastic nodule” was an associated factor of 1-year HCC occurrence and recurrence. To investigate existence of “dysplastic nodule” by imaging surveillance before DAA treatment is useful to detect high-risk patients of very early HCC occurrence and recurrence and it should be performed.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan

    Yoshihiko Ooka, Masato Nakamura, Sadahisa Ogasawara, Eiichiro Suzuki, Shin Yasui, Tetsuhiro Chiba, Makoto Arai, Hitoshi Maruyama, Osamu Yokosuka & Naoya Kato

  2. Department of Gastroenterology, Yamanashi Central Hospital, Kofu, Yamanashi, Japan

    Kanda Miho, Hitoshi Mochizuki & Masao Omata

  3. Third Department of Internal Medicine, Teikyo University School of Medicine, Chiba, Japan

    Obi Shuntaro

  4. Department of Gastroenterology, Nihon University School of Medicine, Tokyo, Japan

    Tatsuo Kanda

  5. University of Tokyo, Tokyo, Japan

    Masao Omata

Authors
  1. Yoshihiko Ooka
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  2. Kanda Miho
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  3. Obi Shuntaro
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  4. Masato Nakamura
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  6. Eiichiro Suzuki
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  7. Shin Yasui
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  8. Tetsuhiro Chiba
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  9. Makoto Arai
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  10. Tatsuo Kanda
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  11. Hitoshi Maruyama
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  12. Osamu Yokosuka
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  13. Naoya Kato
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  14. Hitoshi Mochizuki
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  15. Masao Omata
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Corresponding author

Correspondence to Yoshihiko Ooka.

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This study was approved by the institutional review boards and ethics committees at two hospitals.

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Ooka, Y., Miho, K., Shuntaro, O. et al. Prediction of the very early occurrence of HCC right after DAA therapy for HCV infection. Hepatol Int 12, 523–530 (2018). https://doi.org/10.1007/s12072-018-9895-5

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  • DOI: https://doi.org/10.1007/s12072-018-9895-5

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