APASL HCV guidelines of virus-eradicated patients by DAA on how to monitor HCC occurrence and HBV reactivation

APASL HCV guidelines of virus-eradicated patients by DAA on how to monitor HCC occurrence and HBV reactivation.

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Item Type: Article
Status: Published
Official URL: https://doi.org/10.1007/s12072-019-09988-7
Journal or Publication Title: Hepatology International
Volume: 13
Number: 6
Page Range: pp. 649-661
Date: 2019
Divisions: Liver Injury and Cancer
Depositing User: General Admin
Identification Number: 10.1007/s12072-019-09988-7
ISSN: 1936-0533
Date Deposited: 21 Dec 2020 23:26
Abstract:

In the direct-acting antiviral (DAA) era for hepatitis C virus (HCV) infection, sustained virological response (SVR) is very high, but close attention must be paid to the possible occurrence of hepatocellular carcinoma (HCC) and reactivation of hepatitis B virus (HBV) in patients with co-infection who achieved SVR in short term. HCC occurrence was more often observed in patients with previous HCC history. We found occurrence of HCC in 178 (29.6%) of 602 patients with previous HCC history (15.4 months mean follow-up post-DAA initiation) but, in contrast, in only 604 (1.3%) of 45,870 patients without previous HCC history (18.2 months mean follow-up). Thus, in these guidelines, we recommend the following: in patients with previous HCC history, surveillance at 4-month intervals for HCC by ultrasonography (US) and tumor markers should be performed. In patients without previous HCC history, surveillance at 6- to 12-month intervals for HCC including US is recommended until the long-term DAA treatment effects, especially for the resolution of liver fibrosis, are confirmed. This guideline also includes recommendations on how to follow-up patients who have been infected with both HCV and HBV. When HCV was eradicated in these HBsAg-positive patients or patients with previous HBV infection (anti-HBc and/or anti-HBs-positive), it was shown that HBV reactivation or HBV DNA reappearance was observed in 67 (41.4%) of 162 or 12 (0.9%) of 1317, respectively. For these co-infected patients, careful attention should be paid to HBV reactivation for 24 weeks post-treatment.

Keywords: DAA; Follow-up; Guideline; HBV; HCC; HCV; SVR.

Creators:
Creators
Email
Kanda, Tatsuo
UNSPECIFIED
Lau, George K. K.
UNSPECIFIED
Wei, Lai
UNSPECIFIED
Moriyama, Mitsuhiko
UNSPECIFIED
Yu, Ming-Lung
UNSPECIFIED
Chuang, Wang-Long
UNSPECIFIED
Ibrahim, Alaaeldin
UNSPECIFIED
Lesmana, Cosmas Rinaldi Adithya
UNSPECIFIED
Sollano, Jose
UNSPECIFIED
Kumar, Manoj
UNSPECIFIED
Jindal, Ankur
UNSPECIFIED
Sharma, Barjesh Chander
UNSPECIFIED
Hamid, Saeed S.
UNSPECIFIED
Kadir Dokmeci, A.
UNSPECIFIED
Mamun-Al-Mahtab
UNSPECIFIED
McCaughan, Geoffrey W.
UNSPECIFIED
Wasim, Jafri
UNSPECIFIED
Crawford, Darrell H. G.
UNSPECIFIED
Kao, Jia-Horng
UNSPECIFIED
Ooka, Yoshihiko
UNSPECIFIED
Yokosuka, Osamu
UNSPECIFIED
Sarin, Shiv Kumar
UNSPECIFIED
Omata, Masao
UNSPECIFIED
Last Modified: 21 Dec 2020 23:26
URI: https://eprints.centenary.org.au/id/eprint/137

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