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  • Aleman, SooKarolinska Institutet (author)

A Risk for Hepatocellular Carcinoma Persists Long-term After Sustained Virologic Response in Patients With Hepatitis C-Associated Liver Cirrhosis

  • Article/chapterEnglish2013

Publisher, publication year, extent ...

  • 2013-04-24
  • Oxford University Press (OUP),2013

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  • LIBRIS-ID:oai:lup.lub.lu.se:1d02c6a2-0c46-4b92-ba17-be8f854df49f
  • https://lup.lub.lu.se/record/3979534URI
  • https://doi.org/10.1093/cid/cit234DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:126894074URI

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  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

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  • Background. The long-term effect of sustained virologic response (SVR) to antiviral therapy on the risk of developing hepatocellular carcinoma (HCC), liver complications, liver-related death, and overall death in hepatitis C virus (HCV)-infected patients with liver cirrhosis is not fully known. Methods. These risks were evaluated during long-term follow-up in 351 patients with HCV-related cirrhosis. One hundred ten patients with SVR, 193 with non-SVR, and 48 who were untreated were included in a multicenter cohort that was initiated in 2001 and prospectively followed up for a mean of 5.3 (SD, 2.8) years. Complementary follow-up data from national registries were used to minimize the loss of patients during follow-up. Results. Six patients with SVR developed HCC at 0.04, 0.64, 2.4, 7.4, 7.4, and 7.6 years, respectively, after achieving SVR. The incidences of HCC, any liver complication, liver-related death, and overall death per 100 person-years were significantly lower in SVR time with 1.0, 0.9, 0.7, and 1.9, compared to 2.3, 3.2, 3.0, and 4.1 in non-SVR and 4.0, 4.9, 4.5, and 5.1 in untreated time. The long-term consequences did not decline significantly after >3 years versus during the first 3 years of follow-up. Conclusions. The risk for HCC, liver decompensation, and death in patients with liver cirrhosis related to HCV was markedly reduced after SVR, but a long-term risk of developing HCC remains for up to 8 years. Cirrhotic patients with HCV who achieve SVR should therefore maintain long-term surveillance for HCC. Future studies aimed to better identify those with remaining long-term risk for HCC are needed.

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  • Rahbin, Nogol (author)
  • Weiland, OlaKarolinska Institutet (author)
  • Davidsdottir, LoaKarolinska Institutet (author)
  • Hedenstierna, Magnus (author)
  • Rose, Nina (author)
  • Verbaan, HansLund University,Lunds universitet,Gastroenterologi,Forskargrupper vid Lunds universitet,Gastroenterology,Lund University Research Groups(Swepub:lu)medf-hve (author)
  • Stal, PerKarolinska Institutet (author)
  • Carlsson, Tony (author)
  • Norrgren, HansLund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)infek-hn (author)
  • Ekbom, AndersKarolinska Institutet (author)
  • Granath, FredrikKarolinska Institutet (author)
  • Hultcrantz, RolfKarolinska Institutet (author)
  • Karolinska InstitutetGastroenterologi (creator_code:org_t)

Related titles

  • In:Clinical Infectious Diseases: Oxford University Press (OUP)57:2, s. 230-2361537-65911058-4838

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