Long-term outcome and risk stratification in compensated advanced chronic liver disease after HCV-cure

作者：Georg Semmler, Sonia Alonso López, Mònica Pons, Sabela Lens, Elton Dajti, Marie Griemsmann, Alberto Zanetto, Lukas Burghart, Stefanie Hametner‐Schreil, Lukas Hartl, Marisa Manzano, Sergio Rodríguez‐Tajes, Paola Zanaga, Michael Schwarz, María Luisa Gutiérrez García, Mathias Jachs, Anna Pocurull, Benjamín Polo Lorduy, D. Ecker, Beatriz Mateos, Sonia Izquierdo, Yolanda Real, Lorenz Balcar, Juan Antonio Carbonell‐Asins, Michael Gschwantler, Francesco Paolo Russo, Francesco Azzaroli, Benjamin Maasoumy, Thomas Reiberger, Xavier Forns, Joan Genescà, Rafael Bañares, Mattias Mandorfer · 发表于：Hepatology · 年份：2024 · DOI：10.1097/hep.0000000000001005 · 被引用次数：15 · 研究领域：Hepatitis C virus research、Liver Disease and Transplantation、Liver Disease Diagnosis and Treatment

BACKGROUND AND AIMS: Around 750,000 patients per year will be cured of HCV infection until 2030. Those with compensated advanced chronic liver disease remain at risk for hepatic decompensation and de novo HCC. Algorithms have been developed to stratify risk early after cure; however, data on long-term outcomes and the prognostic utility of these risk stratification algorithms at later time points are lacking. APPROACH AND RESULTS: We retrospectively analyzed a cohort of 2335 patients with compensated advanced chronic liver disease (liver stiffness measurement≥10 kPa) who achieved HCV-cure by interferon-free therapies from 15 European centers (median age 60.2±11.9 y, 21.1% obesity, 21.2% diabetes).During a median follow-up of 6 years, first hepatic decompensation occurred in 84 patients (3.6%, incidence rate: 0.74%/y, cumulative incidence at 6 y: 3.2%); 183 (7.8%) patients developed de novo HCC (incidence rate: 1.60%/y, cumulative incidence at 6 y: 8.3%), with both risks being strictly linear over time.Baveno VII criteria to exclude (FU-liver stiffness measurement <12 kPa and follow-up platelet count >150 g/L) or rule-in (FU-liver stiffness measurement ≥25 kPa) clinically significant portal hypertension (CSPH) stratified the risk of hepatic decompensation with proportional hazards. Estimated probability of CSPH discriminated patients developing versus not developing hepatic decompensation in the gray zone (ie, patients meeting none of the above criteria).Published HCC risk str...