Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index.

Journal Article (Journal Article)

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 interferonbased 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.

Full Text

Duke Authors

Cited Authors

  • Lee, K; Sinn, DH; Gwak, G-Y; Cho, HC; Jung, S-H; Paik, Y-H; Choi, MS; Lee, JH; Koh, KC; Paik, SW

Published Date

  • September 15, 2016

Published In

Volume / Issue

  • 10 / 5

Start / End Page

  • 796 - 802

PubMed ID

  • 27114418

Pubmed Central ID

  • PMC5003204

Electronic International Standard Serial Number (EISSN)

  • 2005-1212

Digital Object Identifier (DOI)

  • 10.5009/gnl15368


  • eng

Conference Location

  • Korea (South)