標題: APASL HCV guidelines of virus-eradicated patients by DAA on how to monitor HCC occurrence and HBV reactivation
作者: Kanda, Tatsuo
Lau, George K. K.
Wei, Lai
Moriyama, Mitsuhiko
Yu, Ming-Lung
Chuang, Wang-Long
Ibrahim, Alaaeldin
Lesmana, Cosmas Rinaldi Adithya
Sollano, Jose
Kumar, Manoj
Jindal, Ankur
Sharma, Barjesh Chander
Hamid, Saeed S.
Dokmeci, A. Kadir
Mamun-Al-Mahtab
McCaughan, Geoffrey W.
Wasim, Jafri
Crawford, Darrell H. G.
Kao, Jia-Horng
Ooka, Yoshihiko
Yokosuka, Osamu
Sarin, Shiv Kumar
Omata, Masao
生物科技學院
College of Biological Science and Technology
關鍵字: HCV;HCC;DAA;SVR;Follow-up;Guideline;HBV
公開日期: 1-十一月-2019
摘要: In the direct-acting antiviral (DAA) era for hepatitis C virus (HCV) infection, sustained virological response (SVR) is very high, but close attention must be paid to the possible occurrence of hepatocellular carcinoma (HCC) and reactivation of hepatitis B virus (HBV) in patients with co-infection who achieved SVR in short term. HCC occurrence was more often observed in patients with previous HCC history. We found occurrence of HCC in 178 (29.6%) of 602 patients with previous HCC history (15.4 months mean follow-up post-DAA initiation) but, in contrast, in only 604 (1.3%) of 45,870 patients without previous HCC history (18.2 months mean follow-up). Thus, in these guidelines, we recommend the following: in patients with previous HCC history, surveillance at 4-month intervals for HCC by ultrasonography (US) and tumor markers should be performed. In patients without previous HCC history, surveillance at 6- to 12-month intervals for HCC including US is recommended until the long-term DAA treatment effects, especially for the resolution of liver fibrosis, are confirmed. This guideline also includes recommendations on how to follow-up patients who have been infected with both HCV and HBV. When HCV was eradicated in these HBsAg-positive patients or patients with previous HBV infection ( anti-HBc and/ or anti-HBs-positive), it was shown that HBV reactivation or HBV DNA reappearance was observed in 67 (41.4%) of 162 or 12 (0.9%) of 1317, respectively. For these co-infected patients, careful attention should be paid to HBV reactivation for 24 weeks post-treatment.
URI: http://dx.doi.org/10.1007/s12072-019-09988-7
http://hdl.handle.net/11536/153411
ISSN: 1936-0533
DOI: 10.1007/s12072-019-09988-7
期刊: HEPATOLOGY INTERNATIONAL
Volume: 13
Issue: 6
起始頁: 649
結束頁: 661
顯示於類別:期刊論文