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KMID : 1188320160100050796
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Gut and Liver
2016 Volume.10 No. 5 p.796 ~ p.802
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Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index
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Lee Keol
Sinn Dong-Hyun
Gwak Geum-Youn
Cho Hyun-Chin
Jung Sin-Ho
Paik Yong-Han
Choi Moon-Seok
Lee Joon-Hyeok
Koh Kwang-Cheol
Paik Seung-Woon
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Abstract
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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.
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KEYWORD
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Carcinoma, hepatocellular, Aspartate aminotransferase to platelet ratio index, Hepatitis C, chronic, Sustained virological response
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