Risk of hepatocellular carcinoma occurrence after antiviral therapy for patients with chronic hepatitis C Infection: a systematic review and meta-analysis

被引:4
作者
Lv, Gui-Ji [1 ,2 ]
Ji, Dong [1 ,2 ,3 ]
Yu, Lingxiang [1 ]
Chen, Hong-Yan [4 ]
Chen, Jing [5 ,6 ]
He, Mengwen [1 ,2 ]
Wang, Wen-Chang [3 ]
Wang, Hong-Bo [1 ]
Tsang, Christopher [6 ]
Wang, Jianjun [1 ]
Yu, Ming-Lung [7 ,8 ]
Lau, George [3 ,6 ,9 ]
机构
[1] Chinese Peoples Liberat Army Gen Hosp, Med Ctr 5, Dept Hepatol, Beijing 100039, Peoples R China
[2] Peking Univ, Clin Med Sch 302, Beijing 100039, Peoples R China
[3] Chinese PLA Med Sch, Beijing 100853, Peoples R China
[4] North China Elect Power Univ, Hosp, Beijing 102206, Peoples R China
[5] Chinese Univ Hong Kong, Fac Med, JC Sch Publ Hlth & Primary Care, Hong Kong, Peoples R China
[6] Humanity & Hlth Clin Trial Ctr, Humanity & Hlth Med Grp, 9 Queens Rd Cent, Hong Kong, Peoples R China
[7] Kaohsiung Med Univ Hosp, Dept Internal Med, Hepatobiliary Div, 100 Tzyou 1st Rd, Kaohsiung 807, Taiwan
[8] Kaohsiung Med Univ Hosp, Hepatitis Ctr, 100 Tzyou 1st Rd, Kaohsiung 807, Taiwan
[9] Fudan Univ, Zhongshan Hosp, Liver Canc Inst, 180 Fenlin Rd, Shanghai 200032, Peoples R China
关键词
Hepatocellular carcinoma; Chronic hepatitis C virus; Sustained virological response; Direct-acting antiviral; Occurrence; SUSTAINED VIROLOGICAL RESPONSE; CIRRHOTIC-PATIENTS; ADVANCED FIBROSIS; VIRUS-INFECTION; ERADICATION;
D O I
10.1007/s12072-024-10700-7
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and AimsThe risk of hepatocellular carcinoma (HCC) occurrence following antiviral therapy in patients with chronic hepatitis C (CHC) remains unclear. The current study aims to compare: (1) the HCC occurrence rate following sustained virological response (SVR) versus non-response (NR); (2) the HCC occurrence rate following direct-acting antiviral (DAA) therapy versus interferon (IFN)-based therapy, and (3) the HCC occurrence rate in SVR patients with or without cirrhosis.MethodsA search was performed for articles published between January 2017 and July 2022. Studies were included if they assessed HCC occurrence rate in CHC patients following anti-HCV therapy. Random effects meta-analysis was used to synthesize the results from individual studies.ResultsA total of 23 studies including 29,395 patients (IFN-based = 6, DAA = 17; prospective = 10, retrospective = 13) were included in the review. HCC occurrence was significantly lower in CHC with SVR (1.54 per 100 person-years (py, 95% CI 1.52, 1.57) than those in non-responders (7.80 py, 95% CI 7.61, 7.99). Stratified by HCV treatment regimens, HCC occurrence following SVR was 1.17 per 100 py (95% CI 1.11, 1.22) and 1.60 per 100 py (95% CI 1.58, 1.63) in IFN- and DAA treatment-based studies. HCC occurrence was 0.85 per 100 py (95% CI 0.85, 0.86) in the non-cirrhosis population and rose to 2.47 per 100 py (95% CI 2.42, 2.52) in the cirrhosis population. Further meta-regression analysis showed that treatment types were not associated with a higher HCC occurrence rate, while cirrhosis status was an important factor of HCC occurrence rate.ConclusionHCC occurrence was significantly lower in the SVR population than in the NR population. HCC risk following SVR occurred three times more frequently in patients with cirrhosis than patients without cirrhosis. However, we found no significant difference in HCC occurrence risk following SVR between DAA and IFN therapies.Clinical trial numberCRD42023473033.
引用
收藏
页码:1459 / 1471
页数:13
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