PREDICTIVE SCORES FOR HEPATOCELLULAR CARCINOMA OCCURRENCE AFTER HEPATITIS C VIRUS CURE WITH DIRECT ANTIVIRALS

  • Cristina MUZICA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. STANCIU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Laura HUIBAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Irina GIRLEANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Oana PETREA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Ramona CADAR “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • S. ZENOVIA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • T. CUCIUREANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • R. NASTASA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Ermina STRATINA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • R. STAFIE “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • A. ROTARU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • H. MINEA “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Ana-Maria SINGEAP “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. SFARTI “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • S. CHIRIAC “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Camelia COJOCARIU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Anca TRIFAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

Hepatitis C virus (HCV) chronic infection has an important tumorigenic propensity and represents a major cause of hepatocellular carcinoma (HCC). Although the therapy of chronic HCV infection has been revolutionized with the introduction of direct acting antivirals (DAAs) resulting in sustained virological response (SVR) in up to 98% of patients, viral clearance does not totally alleviate the risk of liver-related complications, including HCC. The aim of our study was to assess the performance of predictive scores for HCC occurrence in patients with chronic HCV infection who obtained SVR with DAAs. Material and methods: We conducted a prospective study in which we included 992 patients diagnosed with chronic HCV infection and treated with DAAs, between 1st  November 2015 and 31st  December 2020. HCC risk scoring systems were applied to each patient enrolled in the study before starting DAA treatment. HCC was diagnosed by imaging methods such as computed tomography and magnetic resonance imaging. Results: Of the 992 patients included in the study, 59 (5.9%) were diagnosed with HCC during the follow-up period, mostly women (55.9%) with a mean age of 60-69 years. The mean time to HCC onset was 19.53 ± 11.553 months, with a median of 17 months, with a cumulative incidence at 1, 3, and 5 years of 1.1%, 2.1%, and 2.9%, respectively. The General Evaluation Score (GES),  aMAP and ADRESS score had statistically significant higher values in patients with HCC than in those without HCC. GES demonstrated a good  discriminating power with an AUC coefficient of 0.804 at a cut-off value of 6.25 which has good sensitivity and specificity (0.746 and 0.799, respectively). Conclusions: GES score has a very good predictive power for the risk of HCC after obtaining SVR and could be recommended in clinical practice. Future development and validation of other individualized predictive scores score is needed for a correct and cost-efficient selection of patients with high risk of HCC.

Author Biographies

Cristina MUZICA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

C. STANCIU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Laura HUIBAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Irina GIRLEANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Oana PETREA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Ramona CADAR, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Surgery (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
1st Surgical Unit

S. ZENOVIA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

T. CUCIUREANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

R. NASTASA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Ermina STRATINA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

R. STAFIE, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

A. ROTARU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

H. MINEA, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Ana-Maria SINGEAP, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

C. SFARTI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

S. CHIRIAC, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Camelia COJOCARIU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

Anca TRIFAN, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
“Sf. Spiridon” County Clinical Emergency Hospital, Iasi, Romania
Institute of Gastroenterology and Hepatology

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Published
2023-09-30
Section
INTERNAL MEDICINE - PEDIATRICS