Long-term outcome and risk stratification in compensated advanced chronic liver disease after HCV-cure

被引：4

作者：

Semmler, Georg ^{[1
,2
]}

Alonso Lopez, Sonia ^{[3
,4
,5
]}

Pons, Monica ^{[6
]}

Lens, Sabela ^{[7
,8
]}

Dajti, Elton ^{[9
,10
]}

Griemsmann, Marie ^{[11
]}

Zanetto, Alberto ^{[12
]}

Burghart, Lukas ^{[1
,13
]}

Hametner-Schreil, Stefanie ^{[14
]}

Hartl, Lukas ^{[1
,2
]}

Manzano, Marisa ^{[15
]}

Rodriguez-Tajes, Sergio ^{[7
,8
]}

Zanaga, Paola ^{[12
]}

Schwarz, Michael ^{[1
,2
,13
]}

Gutierrez, Maria Luisa ^{[16
]}

Jachs, Mathias ^{[1
,2
]}

Pocurull, Anna ^{[7
,8
]}

Polo, Benjamin ^{[17
]}

Ecker, Dominik ^{[14
]}

Mateos, Beatriz ^{[18
]}

Izquierdo, Sonia ^{[19
]}

Real, Yolanda ^{[20
]}

Balcar, Lorenz ^{[1
,2
]}

Carbonell-Asins, Juan Antonio ^{[21
]}

Gschwantler, Michael ^{[13
]}

Russo, Francesco Paolo ^{[12
]}

Azzaroli, Francesco ^{[9
,10
]}

Maasoumy, Benjamin ^{[11
]}

Reiberger, Thomas ^{[1
,2
]}

Forns, Xavier ^{[7
,8
]}

Genesca, Joan ^{[6
,8
]}

Banares, Rafael ^{[3
,4
,5
]}

Mandorfer, Mattias ^{[1
,2
]}

Agostini, Sofia Maria ^{[7
]}

Battistella, Sara ^{[12
]}

Casanova-Cabral, Michelle ^{[17
]}

Bauer, David Josef Maria ^{[1
,2
]}

Chromy, David ^{[1
,2
]}

Cornberg, Markus ^{[11
]}

Deterding, Katja ^{[11
]}

Fernandez, Inmaculada ^{[15
]}

Fernandez-Rodriguez, Conrado ^{[16
]}

Gea, Francisco ^{[18
]}

Krawanja, Julia ^{[13
]}

Mauz, Jim Benjamin ^{[11
]}

Neumayer, Daniela ^{[1
]}

Ahumada, Adriana ^{[3
]}

Riado, Daniel ^{[3
,16
]}

Rincon, Diego ^{[4
,5
,6
]}

Schwabl, Philipp ^{[1
,2
]}

机构：

[1] Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Wahringer Gurtel 18-20, A-1090 Vienna, Austria

[2] Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, Vienna Hepat Hemodynam Lab, Vienna, Austria

[3] Hosp Gen Univ Gregorio Maranon, Liver Unit, Madrid, Spain

[4] Inst Invest Sanitaria Gregorio Maranon IiSGM, Madrid, Spain

[5] Univ Complutense Madrid, Madrid, Spain

[6] Univ Autonoma Barcelona, Vall dHebron Univ Hosp, Vall dHebron Inst Res VHIR, Liver Unit, Vall dHebron Barcelona Hosp Campus, Barcelona, Spain

[7] Univ Barcelona, Liver Unit, Hosp Clin, IDIBAPS FCRB, Barcelona, Spain

[8] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain

[9] Univ Bologna, Dept Med & Surg Sci DIMEC, Bologna, Italy

[10] IRCCS Azienda Osped Univ Bologna, European Reference Network Hepatol Dis ERN RARE LI, Bologna, Italy

[11] Hannover Med Sch, Dept Gastroenterol Hepatol Infect Dis & Endocrinol, Hannover, Germany

[12] Padua Univ Hosp, Dept Surg Oncol & Gastroenterol, Multivisceral Transplant Unit, Padua, Italy

[13] Klin Ottakring, Dept Internal Med 4, Vienna, Austria

[14] Ordensklinikum Linz Barmherzige Schwestern, Dept Internal Med 4, Linz, Austria

[15] Hosp Univ 12 Octubre, Liver Unit, Madrid, Spain

[16] Hosp Univ Fdn Alcorcon, Gastroenterol Unit, Madrid, Spain

[17] Hosp Univ Fdn Jimenez Diaz, Gastroenterol Unit, Madrid, Spain

[18] Hosp Univ Ramon Y Cajal, Liver Unit, Madrid, Spain

[19] Hosp Univ Clin San Carlos, Gastroenterol Unit, Madrid, Spain

[20] Hosp Univ Princesa, Gastroenterol Unit, Madrid, Spain

[21] Biomed Res Inst INCLIVA, Biostat Unit, Valencia, Spain

来源：

HEPATOLOGY | 2024年

关键词：

Hepatitis C virus; Etiological cure; Sustained virologic response; Hepatocellular carcinoma; Clinically significant portal hypertension; CIRRHOSIS; ERADICATION; PREDICTION; FIBROSIS;

D O I：

10.1097/HEP.0000000000001005

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background & Rationale: Around 750.000 patients/year will be cured from hepatitis C-virus (HCV)-infection until 2030. Those with compensated advanced chronic liver disease (cACLD) remain at risk for hepatic decompensation and de-novo hepatocellular carcinoma (HCC). Algorithms have been developed to stratify risk early after cure, however, data on long-term outcome and the prognostic utility of these risk stratification algorithms at later timepoints are lacking. Main Results: We retrospectively analysed a cohort of 2335 cACLD-patients (LSM >= 10kPa) who achieved HCV-cure by interferon-free therapies from 15 European centres (median age 60.2 +/- 11.9 y, 21.1% obesity, 21.2% diabetes). During a median follow-up of 6 years, first hepatic decompensation occurred in 84 patients (3.6%, incidence rate [IR]: 0.74%/year, cumulative incidence at 6 y: 3.2%); 183 (7.8%) patients developed de-novo HCC (IR: 1.60%/year, cumulative incidence at 6 y: 8.3%), with both risks being strictly linear over time. Baveno VII criteria to exclude (FU-LSM <12kPa & FU-PLT >150 G/L) or rule-in (FU-LSM >= 25kPa) clinically significant portal hypertension (CSPH) stratified the risk of hepatic decompensation with proportional hazards. Estimated probability of CSPH discriminated patients developing versus not developing hepatic decompensation in the grey-zone (i.e., patients meeting none of the above criteria). Published HCC risk stratification algorithms identified high- and low-incidence groups, however, the size of the latter group varied substantially (9.9%-69.1%). A granular 'HCC-SVR' model was developed to inform on an individual patient's HCC-risk after HCV-cure. Conclusion: In patients with cACLD, the risks of hepatic decompensation and HCC remain constant after HCV-cure, even in the long-term (>3 y). One-time post-treatment risk stratification based on non-invasive criteria provides important prognostic information that is maintained during long-term follow-up, as the hazards remain proportional over time.

引用

页数：41

共 42 条

[1] Noninvasive Tools and Risk of Clinically Significant Portal Hypertension and Varices in Compensated Cirrhosis: The "Anticipate" Study [J].

Abraldes, Juan G. ;

Bureau, Christophe ;

Stefanescu, Horia ;

Augustin, Salvador ;

Ney, Michael ;

Blasco, Helene ;

Procopet, Bogdan ;

Bosch, Jaime ;

Genesca, Joan ;

Berzigotti, Annalisa .

HEPATOLOGY, 2016, 64 (06) :2173-2184

[2] Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity [J].

Alberti, K. G. M. M. ;

Eckel, Robert H. ;

Grundy, Scott M. ;

Zimmet, Paul Z. ;

Cleeman, James I. ;

Donato, Karen A. ;

Fruchart, Jean-Charles ;

James, W. Philip T. ;

Loria, Catherine M. ;

Smith, Sidney C., Jr. .

CIRCULATION, 2009, 120 (16) :1640-1645

[3] A Model Based on Noninvasive Markers Predicts Very Low Hepatocellular Carcinoma Risk After Viral Response in Hepatitis C Virus-Advanced Fibrosis [J].

Alonso Lopez, Sonia ;

Manzano, Maria Luisa ;

Gea, Francisco ;

Gutierrez, Maria Luisa ;

Ahumada, Adriana Maria ;

Devesa, Maria Jose ;

Olveira, Antonio ;

Polo, Benjamin Arturo ;

Marquez, Laura ;

Fernandez, Inmaculada ;

Cobo, Juan Carlos Ruiz ;

Rayon, Laura ;

Riado, Daniel ;

Izquierdo, Sonia ;

Uson, Clara ;

Real, Yolanda ;

Rincon, Diego ;

Fernandez-Rodriguez, Conrado M. ;

Banares, Rafael .

HEPATOLOGY, 2020, 72 (06) :1924-1934

[4]

[Anonymous], 2023, EASL Policy Statement: risk-based surveillance for hepatocellular carcinoma among patients with cirrhosis, V41

[5]

Berenguer J, 2025, HEPATOLOGY, V81, P238, DOI 10.1097/HEP.0000000000000838

[6] Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study [J].

Blach, Sarah ;

Terrault, Norah A. ;

Tacke, Frank ;

Gamkrelidze, Ivane ;

Craxi, Antonio ;

Tanaka, Junko ;

Waked, Imam ;

Dore, Gregory J. ;

Abbas, Zaigham ;

Abdallah, Ayat R. ;

Abdulla, Maheeba ;

Aghemo, Alessio ;

Aho, Inka ;

Akarca, Ulus S. ;

Alalwan, Abduljaleel M. ;

Blome, Marianne Alanko ;

Al-Busafi, Said A. ;

Aleman, Soo ;

Alghamdi, Abdullah S. ;

Al-Hamoudi, Waleed K. ;

Aljumah, Abdulrahman A. ;

Al-Naamani, Khalid ;

Al Serkal, Yousif M. ;

Altraif, Ibrahim H. ;

Anand, Anil C. ;

Anderson, Motswedi ;

Andersson, Monique, I ;

Athanasakis, Kostas ;

Baatarkhuu, Oidov ;

Bakieva, Shokhista R. ;

Ben-Ari, Ziv ;

Bessone, Fernando ;

Biondi, Mia J. ;

Bizri, Abdul Rahman N. ;

Mello, Carlos E. Brandaoo ;

Brigida, Krestina ;

Brown, Kimberly A. ;

Brown, Robert S., Jr. ;

Bruggmann, Philip ;

Brunetto, Maurizia R. ;

Busschots, Dana ;

Buti, Maria ;

Butsashvili, Maia ;

Cabezas, Joaquin ;

Chae, Chungman ;

Ivanova, Viktorija Chaloska ;

Chan, Henry Lik Yuen ;

Cheinquer, Hugo ;

Cheng, Kent Jason ;

Cheon, Myeong Eun .

LANCET GASTROENTEROLOGY & HEPATOLOGY, 2022, 7 (05) :396-415

[7]

Canty A, 2017, R package, V1, P3

[8] Hepatocellular Carcinoma Incidence Threshold for Surveillance in Virologically Cured Hepatitis C Individuals [J].

Chhatwal, Jagpreet ;

Hajjar, Ali ;

Mueller, Peter P. ;

Nemutlu, Gizem ;

Kulkarni, Neeti ;

Peters, Mary Linton B. ;

Kanwal, Fasiha .

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2024, 22 (01) :91-101

[9] Baveno VII - Renewing consensus in portal hypertension [J].

de Franchis, Roberto ;

Bosch, Jaime ;

Garcia-Tsao, Guadalupe ;

Reiberger, Thomas ;

Ripoll, Cristina .

JOURNAL OF HEPATOLOGY, 2022, 76 (04) :959-974

[10]

European Assoc Study Liver, 2018, J HEPATOL, V69, P182, DOI 10.1016/j.jhep.2018.03.019

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