Could Liver Stiffness Aid in Predicting Liver Cancer Risk in Hep C?
Liver stiffness measurements during and after antiviral therapy for chronic hepatitis C virus (HCV) can aid in predicting hepatocellular carcinoma (HCC) risk, according to new findings.
Researchers arrived at this conclusion following a study of 1146 patients with chronic HCV. Liver stiffness values were recorded for all patients at enrollment. Among 752 patients, the researchers assessed chronological changes in liver stiffness based on antiviral therapy and its outcome. Mean follow-up lasted 6.6 years.
A total of 190 patients developed HCC over the course of follow-up. At year 5, cumulative incidence rates of HCC were:
1.7% in patients with liver stiffness measurements of 5 kilopascals (kPa) or lower.
- 3.3% in 5.1 kPa to 10 kPa
- 16.7% in 10.1 kPa to 15 kPa
- 24.4% in 15.1 kPa to 20 kPa
- 36.3% in 20.1 kPa to 25 kPa
- 43.7% in subgroups with over 25 kPa
Rates of overall survival at year 10 were:
- 99.3% in patients with less than 5 kPa
- 95.4% in 5.1 kPa to 10 kPa
- 81.4% in 10.1 kPa to 15 kPa
- 79.5% in 15.1 kPa to 20 kPa
- 66.1% in 20.1 kPa to 25 kPa
- 49.1% in in subgroups with over 25 kPa
Antiviral therapy status was found to play a role in liver stiffness. In patients who achieved sustained virological response (SVR), liver stiffness decreased at a rate of 8.1% per year. However, in patients without SVR, liver stiffness increased at a rate 0.1% per year. Among patients who did not receive antiviral therapy, liver stiffness increased at 3.7% per year.
“Liver stiffness measurements can be useful in the prediction of HCC development and overall survival and in the evaluation of chronological changes in liver ﬁbrosis grade during and after antiviral therapy,” the researchers wrote.
Nakagomi R, Tateishi R, Masuzaki R, et al. Liver stiffness measurements in chronic hepatitis C: Treatment evaluation and risk assessment [Published online November 4, 2018]. J Clin Gastroenterol Hepatol. doi:10.1111/jgh.14530.