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The risks of first hepatic decompensation and HCC remain constant during long-term follow-up and can be stratified by a one-time assessment after HCV-cure
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several in audience expressed concern about this approach, not conducting ultrasound/MRI surveillance, too much risk, "its easy to perform ultrasound". Jules
Georg Semmler1,2, Sonia Alonso Lopez3,4,5, Monica Pons6,
Sabela Lens7, Elton Dajti8, Marie Griemsmann9, Alberto Zanetto10, Lukas Burghart11, Stephanie Hametner-Schreil12, Lukas Hartl1,2, Adriana Ahumada3, Sergio Rodriguez-Tajes7, Paola Zanaga10, Michael Schwarz1,2,11, Clara Uson3, Mathias Jachs1,2, Anna Pocurull7, Maria Luisa Manzano Alonso13, Dominik Ecker12, Daniel Riado14, Beatriz Mateos Muņoz15, Michael Gschwantler11,
Francesco Paolo Russo10, Francesco Azzaroli8, Benjamin Maasoumy9, Thomas Reiberger1,2, Xavier Forns7, Joan Genesca6,16,
Rafael Baņares3,4,5, Mattias Mandorfer1,2
Background and aims: The number of individuals who will be treated for and cured from HCV infection world-wide is expected to exceed 1 million per year for the next decade. In those with compensated advanced chronic liver disease (cACLD), the risks of de-novo hepatocellular carcinoma (HCC) and hepatic decompensa-tion are decreased but not completely abolished by HCV-cure. Thus, risk stratification is key to decrease resource utilization by individualizing post-treatment management. We evaluated whether the incidences of HCC and hepatic decompensation decrease with time after HCV-cure and whether the discriminatory ability of a one-time post-treatment assessment is maintained during long-term follow-up.
Method: We retrospectively analyzed cACLD patients with paired liver stiffness measurement (LSM) and platelet count (PLT) before and after HCV-cure by interferon-free therapies from 7 European regions. Cumulative incidence curves were used to estimate the incidence of hepatic decompensation/HCC over time in the overall group and throughout previously defined risk strata (i.e., Baveno VII criteria for clinically significant portal hypertension after HCV-cure and Semmler et al. J Hepatol 2022 for HCC).
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