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 |