Simple scoring system for prediction of hepatocellular carcinoma occurrence after hepatitis C virus eradication by direct‑acting antiviral treatment: All Kagawa Liver Disease Group Study

Tani,Joji; Morishita,Asahiro; Sakamoto,Teppei; Takuma,Kei; Nakahara,Mai; Fujita,Koji; Oura,Kyoko; Tadokoro,Tomoko; Mimura,Shima; Nomura,Takako; Yoneyama,Hirohito; Kobara,Hideki; Himoto,Takashi; Tsutsui,Akemi; Senoh,Tomonori; Nagano,Takuya; Ogawa,Chikara; Moriya,Akio; Deguchi,Akihiro; Takaguchi,Kouichi; Masaki,Tsutomu

doi:10.3892/ol.2020.11341

Simple scoring system for prediction of hepatocellular carcinoma occurrence after hepatitis C virus eradication by direct‑acting antiviral treatment: All Kagawa Liver Disease Group Study

Authors:
- Joji Tani
- Asahiro Morishita
- Teppei Sakamoto
- Kei Takuma
- Mai Nakahara
- Koji Fujita
- Kyoko Oura
- Tomoko Tadokoro
- Shima Mimura
- Takako Nomura
- Hirohito Yoneyama
- Hideki Kobara
- Takashi Himoto
- Akemi Tsutsui
- Tomonori Senoh
- Takuya Nagano
- Chikara Ogawa
- Akio Moriya
- Akihiro Deguchi
- Kouichi Takaguchi
- Tsutomu Masaki
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Affiliations: Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Miki, Kagawa 761‑0793, Japan, Department of Medical Technology, Kagawa Prefectural University of Health Sciences, Takamatsu, Kagawa 761‑0123, Japan, Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa 760‑8557, Japan, Department of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa 760‑0017, Japan, Department of Gastroenterology, Mitoyo General Hospital, Kanonji, Kagawa 769‑1695, Japan, Department of Gastroenterology, Kagawa Rosai Hospital, Marugame, Kagawa 763‑8502, Japan
Published online on: January 23, 2020 https://doi.org/10.3892/ol.2020.11341
Pages: 2205-2212
Copyright: © Tani et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Direct acting antivirals (DAA) have recently been developed to treat patients with hepatitis C virus (HCV) infection, and interferon‑free DAA treatment has improved the cure rate of patients. However, the occurrence rate of hepatocellular carcinoma (HCC) following HCV eradication remains unknown. Therefore, the present study aimed to identify predictors of HCC occurrence following DAA treatment. Among 1,454 patients infected with HCV, 1,088 patients who achieved sustained virologic response and who had no history of HCC treatment were recruited between September 2014 and November 2018. The incidence of HCC in patients infected with HCV following DAA treatment, and the predictors contributing to HCC occurrence were identified using clinicopathological characteristics and blood test results. During the present study, 26 patients developed HCC. The incidence of HCC was 0.61, 1.88, 2.82 and 3.71% at 6, 12, 18 and 24 months after treatment with DAA, respectively. The results of multivariate analysis identified age [hazard ratio (HR), 1.0729; P=0.0044] and α‑fetoprotein (AFP) level after DAA treatment (HR, 1.0486; P=0.0486) as independent factors that may contribute to HCC occurrence following DAA treatment. By using these two factors, a novel scoring system (0‑2 points) was established to predict HCC occurrence following HCV eradication by DAA treatment. The incidence of HCC at 2 years was 0.3% in the 0 points group, 6.27% in the 1 point group and 18.37% in the 2 points group. In conclusion, AFP level after DAA treatment and age at DAA administration were identified as independent predictors of HCC occurrence in patients that were treated with DAA. The scoring system that was established in the present study is simple and easy, and using pre‑treatment factors may be a convenient tool to predict the risk of HCC occurrence in HCV‑free patients following DAA treatment.

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