ArticleHepatology international2020
HCC risk post-SVR with DAAs in East Asians: findings from the REAL-C cohort.
Article in Hepatology international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Risk of hepatocellular carcinoma occurrence after antiviral therapy for patients with chronic hepatitis C Infection: a systematic review and meta-analysis.Hepatology international · 2024Pooled it
- HCC incidence after hepatitis C cure among patients with advanced fibrosis or cirrhosis: A meta-analysis.Hepatology (Baltimore, Md.) · 2022Pooled it
- Antiviral therapy is associated with achievement of statistical cure of patients undergoing liver resection for hepatocellular carcinoma: a retrospective study.Updates in surgery · 2026Article
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- 2025 KASL clinical practice guidelines for management of hepatitis C.Clinical and molecular hepatology · 2026Article
- The predictive factors of hypozincemia in patients with chronic liver disease.Journal of nutritional science · 2026Article
- Precision Strategy for Hepatocellular Carcinoma Surveillance after Hepatitis C Cure: Debates across Guidelines.Gut and liver · 2025Review
- Normalization of serum alpha fetoprotein after direct acting antivirals in hepatitis C patients lowers hepatocellular carcinoma risk.Scientific reports · 2025Article
- Metabolic dysfunction-associated steatotic liver disease affects the development of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients.Journal of gastroenterology · 2025Article
- Hepatocellular carcinoma in patients without cirrhosis.World journal of gastroenterology · 2025Review
- Long-Term Hepatic and Extrahepatic Outcomes of Chronic Hepatitis C Patients After Sofosbuvir-Based Treatment (LONGHEAD Study).Infectious diseases and therapy · 2025Article
- I Can C Clearly Now, the End Is Near.Digestive diseases and sciences · 2025Article
- Benefits of Hepatitis C Viral Eradication: A Real-World Nationwide Cohort Study in Taiwan.Digestive diseases and sciences · 2024Article
- Prognosis Following Sustained Virologic Response in Korean Chronic Hepatitis C Patients Treated with Sofosbuvir-Based Treatment: Data from a Multicenter Prospective Observational Study up to 7 Years.Medicina (Kaunas, Lithuania) · 2024Observational
- Unmet needs in the post-direct-acting antivirals era: The risk and molecular mechanisms of hepatocellular carcinoma after hepatitis C virus eradication.Clinical and molecular hepatology · 2024Review
- Global burden and trends of acute viral hepatitis among children and adolescents from 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019.Hepatology international · 2024Article
- Lysyl oxidase-like 2 as a predictor of hepatocellular carcinoma in patients with hepatitis C virus after sustained virological response.Scientific reports · 2024Article
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- Role of albumin-bilirubin score in non-malignant liver disease.World journal of gastroenterology · 2024Article
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Authors and funding
36 authors at 15 institutions in 5 countries.
Funding
Abstract
backgroundDespite HCV cure, patients remain at risk for HCC, but risk factor data for HCC following SVR are limited for Asian patients.
methodsTo address this gap, we analyzed 5814 patients (5646 SVR, 168 non-SVR) from the Real-World Evidence from the Asia Liver Consortium for HCV (REAL-C) who did not have HCC or a history of HCC at baseline (pre-DAA treatment) and did not develop HCC within 6 months of baseline. To assess the effect of SVR on HCC incidence, we used 1:4 propensity score matching [(PSM), age, sex, baseline cirrhosis, and baseline AFP] to balance the SVR and non-SVR groups.
resultsIn the PSM cohort (160 non-SVR and 612 SVR), the HCC incidence rate per 100 person years was higher in the non-SVR compared to the SVR group (5.26 vs. 1.94, p < 0.001). Achieving SVR was independently associated with decreased HCC risk (adjusted HR [aHR]: 0.41, p = 0.002). Next, we stratified the SVR cohort of 5646 patients to cirrhotic and noncirrhotic subgroups. Among cirrhotic SVR patients, aged ≥ 60, having an albumin bilirubin grade (ALBI) of 2 or 3 (aHR: 2.5, p < 0.001), and baseline AFP ≥ 10 ng/mL (aHR: 1.6, p = 0.001) were associated with higher HCC risk, while among the non-cirrhotic SVR group, only baseline AFP ≥ 10 ng/mL was significant (aHR: 4.26, p = 0.005).
conclusionsAchieving SVR decreases HCC risk; however, among East Asians, patients with elevated pretreatment AFP remained at risk. Pretreatment AFP, an easily obtained serum marker, may provide both prognostic and surveillance value for HCC in East Asian patients who obtained SVR.
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