High incidence of hepatocarcinoma in patients with advanced fibrosis treated with direct-acting antiviral agents for hepatitis C: A real-world retrospective study.

BACKGROUND: Patients treated with direct-acting antivirals for hepatitis C exhibit high cure rates and improved survival. However, there is limited knowledge on their long-term clinical evolution. AIMS: In this study, we aimed to analyse the risk of hepatocarcinoma and hepatic decompensation in patients treated with direct-acting antivirals. METHODS: We conducted a retrospective single-centre study of Portuguese patients with advanced fibrosis treated with direct-acting antiviral agents between 2015 and 2022 at a tertiary hospital. RESULTS: Out of 460 patients, 50 (10.9 %) developed hepatocarcinoma and 36 (7.8 %) experienced hepatic decompensation. The risk for hepatocarcinoma was higher in patients aged over 55 (HR 4.87, 95 % CI 2.34-10.13, p < 0.001), with signs of portal hypertension (HR 3.83, 95 % CI 2.05-7.13, p < 0.001) and arterial hypertension (HR 1.98, 95 % CI 1.09-3.58, p = 0.024). Alcohol consumption (HR 3.30, 95 % CI 1.22-8.94, p = 0.019), signs of portal hypertension (HR 4.56, 95 % CI 2.19-9.48, p < 0.001) and hepatocarcinoma (HR 3.47, 95 % CI 1.69-7.10, p < 0.001) increased the risk of hepatic decompensation. CONCLUSION: Our study found a high incidence of hepatocarcinoma and hepatic decompensation, along with high mortality, in patients with advanced fibrosis treated with direct-acting antivirals. We identified risk factors such as arterial hypertension, alcohol consumption, and signs of portal hypertension, highlighting their role in clinical management and patient monitoring.

Mechanical and Thermal Characterization of Bamboo and Interlaminar Hybrid Bamboo/Synthetic Fibre-Reinforced Epoxy Composites.

The main objective of this study was to investigate the mechanical and thermal properties of bamboo, as well as interlaminar hybrid composites reinforced with both bamboo and synthetic fibres in an epoxy matrix. Bamboo and glass, aramid, and carbon bidirectional fabrics were used with a bi-component epoxy matrix to fabricate the composite materials using the vacuum bagging process. The synthetic fabrics were placed on the outer layers, while the bamboo fabrics were used as the core of the hybrid composites. The developed composites were characterized and compared in terms of morphological, physical, and mechanical properties. Further, thermogravimetric (TGA) analysis was used to measure and compare the degradation temperature of the composites studied. Finally, a Scanning Electron Microscopy (SEM) analysis was performed in order to examine the fracture surfaces of the specimens tested. It was found that the fibre hybridization technique significantly improved the general mechanical properties. TGA analysis showed an increase in the thermal stability of the composites obtained by incorporating the synthetic fibres, confirming the effect of hybridization and efficient fibre matrix interfacial adhesion. The results from this work showed that the use of synthetic fibre reinforcements can help to significantly improve the mechanical and thermal properties of bamboo fibre-reinforced composites.