Prediction and surveillance of de novo HCC in patients with compensated advanced chronic liver disease after hepatitis C virus eradication with direct antiviral agents

Frontiers in Virology

Virology

Abdulla A. Mahmoud¹  Ali Madian²  Hussein H. Aly³  Mohamed Alboraie⁴  Sadek Mostafa⁴  Ashraf Elbahrawy⁴  Ahmed Eliwa⁴  Alaa Alsawak⁴  Ahmed Alwassief⁵  Hassan Atalla⁶  Ahmed Alashker⁷ 

[1] Chemistry Department, Faculty of Science, Helwan University, Cairo, Egypt;School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan;Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Assiut, Egypt;Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan;Gastroenterology and Hepatology Unit, Department of Internal Medicine, Al-Azhar University, Cairo, Egypt;Gastroenterology and Hepatology Unit, Department of Internal Medicine, Al-Azhar University, Cairo, Egypt;Gastroenterology Unit, Department of Internal Medicine, Sultan Qaboos University Hospital, Muscat, Oman;Hepatology and Gastroenterology Unit, Department of Internal Medicine, Mansoura University, Mansoura, Egypt;Nephrology Unit, Department of Internal Medicine, Al-Azhar University, Cairo, Egypt;

关键词: HCC;    cACLD;    DAA;    HCV;    predictors;    screening;   

DOI  :  10.3389/fviro.2023.1227317

 received in 2023-05-23, accepted in 2023-10-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

The risk of hepatocellular carcinoma (HCC) diminishes in patients with hepatitis C virus (HCV)-related advanced chronic liver disease after virological cure. However, despite viral clearance, HCV-induced epigenetic alterations, immune dysregulations, and hepatic parenchymal injuries remain, contributing to de novo HCC occurrence. While HCC incidence is low (0.45 – 0.5%) in patients with advanced fibrosis (F3), the presence of liver cirrhosis and clinically significant portal hypertension increases the HCC risk. The cost-effectiveness of lifelong HCC surveillance in patients with compensated advanced chronic liver disease (cACLD) has sparked debate, raising questions about the most reliable noninvasive tests and stratification models for predicting HCC in patients with sustained virological response (SVR). Furthermore, identifying cACLD patients who may not require long-term HCC surveillance after SVR remains crucial. Several HCC risk stratification scores have been suggested for patients with cACLD, and emerging evidence supports individualized care based on personalized risk assessments. This review focuses on revising the pretreatment and posttreatment predictors of HCC, as well as the indications for HCC surveillance in cACLD patients treated with direct-acting antivirals.

【 授权许可】

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Copyright © 2023 Elbahrawy, Atalla, Mahmoud, Eliwa, Alsawak, Alboraie, Madian, Alashker, Mostafa, Alwassief and Aly