ArticleMetabolism open2021
Non-alcoholic fatty liver disease is a risk factor for occurrence of hepatocellular carcinoma after sustained virologic response in chronic hepatitis C patients: A prospective four-years follow-up study.
Article in Metabolism open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Association between metabolic risk factors and hepatocellular carcinoma: a systematic review and meta-analysis of cohort studies.Frontiers in medicine · 2026Pooled it
- Liver reprogramming toward hepatocellular carcinoma following hepatitis C sustained virologic response: a narrative review.Translational gastroenterology and hepatology · 2026Review
- Prediction of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy Using Agile 3+ and End-of-Treatment Alpha-Fetoprotein Levels in Patients With Hepatitis C.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Steatotic liver disease and chronic viral hepatitis.Clinical and experimental hepatology · 2025Review
- 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
- Metabolic dysfunction-associated steatotic liver disease and its associated health risks.Journal of the Chinese Medical Association : JCMA · 2025Review
- Review
- Epidemiology, pathophysiology and clinical aspects of Hepatocellular Carcinoma in MAFLD patients.Hepatology international · 2024Review
- 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
- Noninvasive Fibrosis Assessment in Chronic Hepatitis C Infection: An Update.Journal of clinical and translational hepatology · 2023Review
- MAFLD: an optimal framework for understanding liver cancer phenotypes.Journal of gastroenterology · 2023Review
- Enlargement of the Spleen Index Is a Predictor of the Occurrence of Esophageal Varices and Hepatocellular Carcinoma after Administering Direct-acting Antiviral Agents.Internal medicine (Tokyo, Japan) · 2023Observational
- Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort.Journal of cannabis research · 2022Article
- Clinical and Molecular Basis of Hepatocellular Carcinoma after Hepatitis C Virus Eradication.Pathogens (Basel, Switzerland) · 2022Review
- MAFLD enhances clinical practice for liver disease in the Asia-Pacific region.Clinical and molecular hepatology · 2022Review
- Response of Human Liver Tissue to Innate Immune Stimuli.Frontiers in immunology · 2022Article
- The Impact of Steatosis on Chronic Hepatitis C Progression and Response to Antiviral Treatments.Biomedicines · 2021Review
- The LAC Score Indicates Significant Fibrosis in Patients With Chronic Drug-Induced Liver Injury: A Large Biopsy-Based Study.Frontiers in pharmacology · 2021Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimThe incidence of hepatocellular carcinoma (HCC) decreases significantly in chronic hepatitis C (CHC) patients with sustained virologic response (SVR) after pegylated-interferon plus ribavirin (PR) or direct-acting antiviral (DAAs) therapy. We follow-up a single cohort of CHC patients to identify risk factors associated with HCC development post-SVR.
methodCHC patients with SVR in Beijing/Hong Kong were followed up at 12-24 weekly intervals with surveillance for HCC by ultrasonography and alpha-fetoprotein (AFP). Multivariate Cox proportional hazards regression analysis was used to explore factors associated with HCC occurrence.
resultsBetween October 2015 and May 2017, SVR was observed in 519 and 817 CHC patients after DAAs and PR therapy respectively. After a median post -SVR follow-up of 48 months, HCC developed in 54 (4.4%) SVR subjects. By adjusted Cox analysis, older age (≥55 years) [HR 2.4, 95% CI (1.3-4.3)], non-alcoholic fatty liver diseases [HR 2.4, 95%CI (1.3-4.2), higher AFP level (≥20 ng/ml) [HR 3.4, 95%CI (2.0-5.8)], higher liver stiffness measurement (≥14.6 kPa) [HR 4.2, 95%CI (2.3-7.6)], diabetes mellitus [HR 4.2, 95%CI (2.4-7.4)] at pre-treatment were associated with HCC occurrence. HCC patients in the DAAs induced SVR group had a higher prevalence of NAFLD as compared with those in the PR induced SVR group, 62% (18/29) vs 28% (7/25), p = 0.026. A nomogram formulated with the above six independent variables had a Concordance-Index of 0.835 (95% CI 0.783-0.866).
conclusionUnderlying NAFLD is associated with increased incidence of HCC in chronic HCV patients post-SVR, particularly in those treated with DAA.
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