Title :

Non-virological factors are drivers of Hepatocellular Carcinoma in virosuppressed Hepatitis B cirrhosis: results of ANRS CO12 CirVir cohort.

Author(s) :

Brichler, Segolene [Auteur]
Nahon, Pierre [Auteur]
Zoulim, Fabien [Auteur]
Layese, Richard [Auteur]
Bourcier, Valerie [Auteur]
Audureau, Etienne [Auteur]
Sutton, Angela [Auteur]
Letouze, Eric [Auteur]
Cagnot, Carole [Auteur]
Marcellin, Patrick [Auteur]
Guyader, Dominique [Auteur]
Roulot, Dominique [Auteur]
Pol, Stanislas [Auteur]
De Ledinghen, Victor [Auteur]
Zarski, Jean-Pierre [Auteur]
Cales, Paul [Auteur]
Tran, Albert [Auteur]
Peron, Jean-Marie [Auteur]
Mallat, Ariane [Auteur]
Riachi, Ghassan [Auteur]
Grange, Jean-Didier [Auteur]
Blanc, Jean-Frederic [Auteur]
Bacq, Yannick [Auteur]
Ouzan, Denis [Auteur]
Bronowicki, Jean-Pierre [Auteur]
Mathurin, Philippe [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Larrey, Dominique [Auteur]
Alric, Laurent [Auteur]
Attali, Pierre [Auteur]
Serfaty, Lawrence [Auteur]
Pilette, Christophe [Auteur]
Bourliere, Marc [Auteur]
Thabut, Dominique [Auteur]
Silvain, Christine [Auteur]
Wartelle, Claire [Auteur]
Zucman, David [Auteur]
Christidis, Christos [Auteur]
Roudot-Thoraval, Francoise [Auteur]
Ganne-Carrie, Nathalie [Auteur]

Journal title :

Journal of viral hepatitis

Abbreviated title :

J. Viral Hepat.

Publication date :

2018-10-31

ISSN :

1365-2893

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Worldwide, hepatocellular carcinoma (HCC) occurs mainly in Asian patients with hepatitis B virus (HBV) infection. This study aimed to decipher the environmental and virological factors associated with HCC occurrence and ...
Show more >Worldwide, hepatocellular carcinoma (HCC) occurs mainly in Asian patients with hepatitis B virus (HBV) infection. This study aimed to decipher the environmental and virological factors associated with HCC occurrence and validate risk scoring systems in a French multicenter prospective cohort of HBV-cirrhotic patients. Patients with biopsy-proven Child-Pugh A viral cirrhosis included in the ANRS CO12 CirVir cohort who were HBsAg(+) without hepatitis C co-infection were selected for: i) interview through a standardized questionnaire reporting coffee consumption and HCC familial history; ii) HBsAg quantification using baseline and sequential two-year frozen sera; iii) baseline HBV genotype determination; and iv) assessment of risk factors and applicability of HCC risk scores (Kaplan-Meier analysis, Cox models). Among 317 patients studied (261 men, median age 53 years, past or ongoing antiviral treatment 93.3%, and baseline detectable HBV DNA in 88 patients), the baseline and 2-year median HBsAg levels were 810 and 463 IU/mL, respectively. After a median follow-up of 65.2 months, 27 HCC cases were diagnosed (annual incidence: 1.6%). Three factors were independently associated with HCC occurrence: age >50 years, platelets </=150 x 10(3) /mm(3) and body mass index >/=30 kg/m(2) . Two out of five risk scores were validated, and the most accurate was PAGE-B at one year. Moreover, HCC in patients without maintained virological suppression seem more aggressive and less accessible to curative treatment. In CONCLUSION: in French patients with HBV cirrhosis mostly virally suppressed, independent HCC risk factors were host-related (age, obesity) or linked to the severity of cirrhosis (thrombopenia), and the European PAGE-B score was the most accurate risk score. This article is protected by copyright. All rights reserved.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Inflammatory digestive disease : pathophysiology and therapeutic targets developement

Submission date :

2019-03-01T14:17:35Z