Dynamic α-fetoprotein, platelets and AST-to-platelet ratio index predict hepatocellular carcinoma in chronic hepatitis C patients with sustained virological response after antiviral therapy.
J Antimicrob Chemother
; 71(7): 1943-7, 2016 07.
Article
em En
| MEDLINE
| ID: mdl-27073265
ABSTRACT
BACKGROUND:
Hepatitis C virus (HCV)-infected patients who achieve viral eradication may still develop hepatocellular carcinoma (HCC). Little is known about the impact of dynamic change of serum markers on HCC development.METHODS:
We enrolled 1351 HCV-infected patients who achieved sustained virological response (SVR). Laboratory data were collected at least 1 year after IFN-based therapy and to the latest follow-up. Data on α-fetoprotein (AFP) were obtained >6 months prior to HCC development to exclude HCC-related AFP elevation.RESULTS:
HCC developed in 49 patients. Risk factors for HCC in SVR patients were old age, liver cirrhosis, higher pre- and post-treatment AFP and high post-treatment AST-to-platelet ratio index (APRI). Patients with pre-AFP ≥15 ng/mLâââpost-AFP ≥15 ng/mL (at 1 year, 23.1%; 5 years, 42.3%) and pre-AFP <15 ng/mLâââpost-AFP ≥15 ng/mL (at 1 year, 25%; 5 years, 50%) had the highest risk of HCC development, followed by pre-AFP ≥15 ng/mLâââpost-AFP <15 ng/mL (at 1 year, 5.2%; 5 years, 7.6%) and pre-AFP <15 ng/mLâââpost-AFP ng/mL <15 ng/mL (at 1 year, 0.5%; 5 years, 0.9%) (Pâ<â0.001). The pattern was similar for platelets and APRI (Pâ<â0.001). SVR patients with pre-APRI ≥0.7âââpost-APRI ≥0.7 had the highest risk of HCC development, followed by comparable risks among the other three groups.CONCLUSIONS:
SVR patients with a persistently high AFP level (≥15 ng/mL) and a high APRI (≥0.7) before and after treatment had the highest incidence of HCC development. Patients with a reduction of AFP and APRI to the normal range after treatment had a markedly decreased risk of HCC. The risk was lowest for patients who kept persistently normal AFP and APRI before and after treatment.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Antivirais
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Contagem de Plaquetas
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Aspartato Aminotransferases
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Alfa-Fetoproteínas
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Carcinoma Hepatocelular
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Hepatite C Crônica
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Resposta Viral Sustentada
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Antimicrob Chemother
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Taiwan