Occurrence of hepatocellular carcinoma following direct antiviral agents (DAA) therapy | ||
| African Journal of Gastroenterology and Hepatology | ||
| Volume 7, Issue 1, 2024, Pages 291-295 PDF (456.82 K) | ||
| Document Type: Original Clinical | ||
| DOI: 10.21608/ajgh.2024.314929.1062 | ||
| Authors | ||
| Sadik Memon1; Madiha Zaki* 2; Bushra Qadir1; Saddat Ali Jiskani1 | ||
| 1Asian institute of medical sciences, Hyderabad, Pakistan. | ||
| 2The University of Modern Sciences, Hyderabad, Pakistan. | ||
| Abstract | ||
| Background and Aim: The study aimed to identify the risk factors associated with hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C virus (HCV) infection treated with direct-acting antivirals (DAAs) in Pakistan. Methods: A retrospective cohort study included 246 patients with chronic HCV infection who received DAA therapy between March 2020 and March 2024. Patients were followed for a median duration of 33 months to monitor the development of HCC. Baseline characteristics and potential risk factors were analyzed using univariate and multivariate analyses to determine their association with HCC occurrence. Results: Of the 246 patients, 34 (13.5%) developed HCC during the follow-up period. Univariate analysis revealed that older age (p<0.001), male gender (p=0.004), lower baseline platelet count (p<0.001), higher baseline alpha-fetoprotein (AFP) level (p<0.001), and the presence of liver cirrhosis (p<0.001) were significantly associated with the development of HCC. Multivariate analysis confirmed that advanced age (HR 1.06, 95% CI 1.03-1.08, p<0.001), male sex (HR 1.86, 95% CI 1.13 3.08, p=0.014), elevated baseline AFP (HR 1.28, 95% CI 1.18-1.39, p<0.001), and liver cirrhosis (HR 4.84, 95% CI 2.78-8.42, p<0.001) were independent predictors of HCC development. Additionally, patients who achieved sustained virological response (SVR) had a significantly lower incidence of HCC compared to those who did not achieve SVR (1.1% vs. 6.9%, p<0.001). Conclusion: This study identifies key risk factors for HCC development in chronic HCV patients treated with DAAs, emphasizing the need for vigilant monitoring, especially in older males with cirrhosis and elevated AFP levels. Achieving SVR significantly reduces the risk of HCC, underscoring the importance of effective antiviral treatment in this population. | ||
| Keywords | ||
| Hepatocellular carcinoma; sustained virological response (SVR); Direct antiviral treatment (DAAS); Chronic Hepatitis C (HCV); alpha-fetoprotein (AFP) | ||
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