Clinical Model for Predicting Hepatocellular Carcinomas in Patients with Post-Sustained Virologic Responses of Chronic Hepatitis C: A Case Control Study

Gut Liver. 2016 Nov 15;10(6):955-961. doi: 10.5009/gnl15321.

Abstract

Background/aims: No clinical model exists to predict the occurrence of hepatocellular carcinoma in sustained virologic response-achieving (HCC after SVR) patients with chronic hepatitis C (CHC).

Methods: We performed a case-control study using a clinical database to research the risk factors for HCC after SVR. A predictive model based on risk factors was established, and the area under the receiver operating characteristic curve (AUC) was calculated.

Results: In the multivariate model, an initial diagnosis of compensated cirrhosis and post-SVR albumin reductions of 1 g/L were associated with 21.7-fold (95% CI, 4.2 to 112.3; p<0.001) and 1.3-fold (95% CI, 1.1 to 1.7; p=0.004) increases in the risk of HCC after SVR, respectively. A predictive model based on an initial diagnosis of compensated cirrhosis (yes, +1; no, 0) and post-SVR albumin ≤36.0 g/L (yes, +1; not, 0) predicted the occurrence of HCC after SVR with a cutoff value of >0, an AUC of 0.880, a sensitivity of 0.833, a specificity of 0.896, and a negative predictive value of 0.956.

Conclusions: An initial diagnosis of compensated cirrhosis combined with a post-SVR albumin value of ≤36.0 g/L predicts the occurrence of HCC after SVR in patients with CHC.

Keywords: Case-control studies; Chronic hepatitis C; Hepatocellular carcinoma; Risk factors; Sustained virologic response.

MeSH terms

  • Antiviral Agents / therapeutic use
  • Carcinoma, Hepatocellular / virology*
  • Case-Control Studies
  • Female
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / drug therapy
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / virology
  • Liver Neoplasms / virology*
  • Male
  • Models, Statistical*
  • Multivariate Analysis
  • Predictive Value of Tests
  • Risk Factors
  • Serum Albumin / analysis
  • Sustained Virologic Response*

Substances

  • Antiviral Agents
  • Serum Albumin