Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index.
- Author:
Keol LEE
1
;
Dong Hyun SINN
;
Geum Youn GWAK
;
Hyun Chin CHO
;
Sin Ho JUNG
;
Yong Han PAIK
;
Moon Seok CHOI
;
Joon Hyeok LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
Author Information
- Publication Type:Original Article
- Keywords: Carcinoma; hepatocellular; Aspartate aminotransferase to platelet ratio index; Hepatitis C; chronic; Sustained virological response
- MeSH: Aspartate Aminotransferases*; Aspartic Acid*; Biomarkers; Blood Platelets*; Carcinoma, Hepatocellular*; Fibrosis; Follow-Up Studies; Hepatitis C; Hepatitis C, Chronic*; Hepatitis, Chronic*; Humans; Incidence; Retrospective Studies
- From:Gut and Liver 2016;10(5):796-802
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Following sustained virological response (SVR) for chronic hepatitis C (CHC) infection, patients with advanced fibrosis require regular monitoring for hepatocellular carcinoma (HCC). The aspartate aminotransferase to platelet ratio index (APRI) is a simple noninvasive surrogate marker known to reflect fibrosis. METHODS: We retrospectively analyzed 598 patients who achieved SVR with interferon-based therapy for CHC. RESULTS: Over a median of 5.1 years of follow-up, there were eight patients diagnosed with HCC and a 5-year cumulative incidence rate of 1.3%. The median pretreatment APRI was 0.83, which decreased to 0.29 after achieving SVR (p<0.001). Both the pre- and posttreatment indices were associated with HCC development. The 5-year cumulative HCC incidence rates were 0% and 2.8% for patients with pretreatment APRI <1.0 and ≥1.0, respectively (p=0.001) and 0.8% and 12.8% for patients with posttreatment APRI <1.0 and ≥1.0, respectively (p<0.001). Pretreatment APRI at a cutoff of 1.0 had a 100% negative predictive value until 10 years after SVR. CONCLUSIONS: HCC development was observed among CHC patients who achieved SVR. The pre- and post-treatment APRI could stratify HCC risk, indicating that the APRI could be a useful marker to classify HCC risk in CHC patients who achieved SVR. However, given the small number of HCC patients, this finding warrants further validation.
