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. 2025 Sep 8.
doi: 10.1111/jgh.70064. Online ahead of print.

Liver Stiffness Measurements After Oral Antivirals Effectively Predict the Risk of HCC in Patients With Chronic Hepatitis C

Yu Rim Lee  1 , Hyun Young Woo  2 , Young Oh Kweon  3 , Won Young Tak  3 , Se Young Jang  3 , Jung Gil Park  4 , Min Kyu Kang  4 , Jeong Eun Song  5 , Byoung Kuk Jang  6 , Changhyeong Lee  5 , Byung Seok Kim  5 , Jae Seok Hwang  6 , Woo Jin Chung  6 , Jeong Heo  2 , Nae-Yun Heo  7 , Seung Ha Park  7 , Jun Sik Yoon  8 , Joonho Jeong  9 , Sang Gyu Kwak  10 , Yeowool Kang  11 , Yang Hyun Baek  11 , Soo Young Park  3
Affiliations

Liver Stiffness Measurements After Oral Antivirals Effectively Predict the Risk of HCC in Patients With Chronic Hepatitis C

Yu Rim Lee et al. J Gastroenterol Hepatol. .

Abstract

Objective: Hepatocellular carcinoma (HCC) can still occur in patients with chronic hepatitis C after achieving a sustained virologic response (SVR) with direct-acting antiviral (DAA) therapy. Therefore, we aimed to identify and validate predictors and HCC risk models using longitudinal data.

Method: This retrospective cohort study included patients who achieved SVR after DAA therapy. Model performance was assessed using Harrell's C-index and the area under the time-dependent receiver operating characteristic curve (AUROC).

Results: After excluding patients who developed HCC or died within 1 year after achieving SVR, a total of 2778 patients were finally included in this study. 154 (5.5%) patients developed HCC at a median of 3.3 years. LSM value showed significant improvement after antiviral therapy (all p < 0.05). In the multivariable analysis, LSM at baseline and 1 year after SVR were significantly associated with the occurrence of HCC (all p < 0.05). LSM at 1 year after SVR could better predict HCC risk than baseline LSM (C-index: 0.760, 0.788 at baseline, 1 year after SVR, respectively). Low-risk patients (LSM < 10 kPa) using LSM values at 1 year after SVR (76.4%) showed an incidence risk of 0.482 incidence rate/100 patient-years. In patients with advanced chronic liver disease, LSM at 1 year after SVR demonstrated superior predictive performance for HCC development compared to baseline LSM and other prediction models assessed at various time points (C-index: 0.744, 95% CI: 0.660-0.829; 3-year follow-up AUROC: 0.794, 95% CI: 0.754-0.831).

Conclusions: LSM after achieving SVR effectively predicts HCC risk, especially in patients with advanced chronic liver disease.

Keywords: hepatitis C virus; hepatocellular carcinoma; liver stiffness; risk score; sustained virological response (SVR).

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References

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