| <Aim> Direct acting antivirals (DAAs) has brought high possibility of SVR to patients infected with HCV. However, suppressive effects on hepatocellular carcinoma (HCC) of DAAs remains unclear. We analyzed HCC incidence among patients who had achieved SVR by DAAs treatment. <Methods> This is a prospective multicenter study. A total of 1749 patients without history of HCC and decompensated cirrhosis who achieved SVR with DAAs were enrolled. <Results> The baseline characteristics were as follows: median age, 68 years old; males, 742 (43%); median platelet counts, 15.2*104 /μL; albumin, 4.0g/dL ; AFP, 4.7ng/mL. At end of treatment (EOT), platelet counts, albumin levels and AFP levels were significantly improved compared to baseline (p<0.001). During observation periods of 14.7 (0.6-35.3) months, 47 patients developed HCC. The cumulative incidence rates of HCC at 6/12/18/24 months were 0.9%/1.6%/3.2%/4.7%, respectively. Cox proportional hazards model identified lower albumin levels at EOT (hazard ratio (HR)=0.228, p=0.005) and AFP levels at EOT (HR=1.020, p<0.001) as independent risk factors related to HCC incidence. The cumulative incidence rates of HCC at 12 months were higher in patients with lower albumin levels (<4.0g/dL) at EOT and higher AFP levels (≥5.0 ng/mL) at EOT rather than those with higher albumin levels and lower AFP levels at EOT (5.5% vs. 0.5%, p<0.001). <Conclusions> Patients with high albumin levels or high AFP levels exhibited high HCC incidence. Additionally, some HCC development occurred even in patients with lower risks. Long follow-up seems required in post-SVR management. |
