Sex difference in the development of hepatocellular carcinoma after direct‐acting antiviral therapy in patients with HCV infection
Sex differences in the predictors for hepatocellular carcinoma (HCC) development after direct‐acting antiviral (DAA) therapy was investigated. DAA therapy was given to 1438 (663 male, 775 female) patients. Sex differences in the HCC development rate and the factors contributing to HCC development af...
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| Veröffentlicht in: | Journal of medical virology 2020-12, Vol.92 (12), p.3507-3515 |
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| creator | Watanabe, Takao Tokumoto, Yoshio Joko, Kouji Michitaka, Kojiro Horiike, Norio Tanaka, Yoshinori Tada, Fujimasa Kisaka, Yoshiyasu Nakanishi, Seiji Yamauchi, Kazuhiko Yukimoto, Atsushi Nakamura, Yoshiko Hirooka, Masashi Abe, Masanori Hiasa, Yoichi |
| description | Sex differences in the predictors for hepatocellular carcinoma (HCC) development after direct‐acting antiviral (DAA) therapy was investigated. DAA therapy was given to 1438 (663 male, 775 female) patients. Sex differences in the HCC development rate and the factors contributing to HCC development after DAA therapy were investigated. Male patients had a significantly higher cumulative HCC incidence (log‐rank test, P = .007). On multivariate analysis, the fibrosis‐4 index (HR = 1.11; 95%CI, 1.042‐1.202, P = .002) and posttreatment α‐fetoprotein (AFP) (HR = 1.11; 95%CI, 1.046‐1.197, P = .001) were found to be independent factors that contributed to HCC development following DAA therapy in female patients, whereas only posttreatment AFP (HR = 1.090; 95%CI, 1.024‐1.160, P = .007) was an independent factor in male patients. The optimal posttreatment AFP cut‐off values were set based on receiver operating characteristic curve analyses. The optimal posttreatment AFP cut‐off value was much higher in females (6.0 ng/mL) than in male (3.5 ng/mL) patients. In conclusion both in male and female patients, posttreatment AFP was an independent predictor of HCC development after DAA therapy. However, the cut‐off values differed between the sexes. In male patients, HCC could be seen in patients with relatively low posttreatment AFP levels; more careful observation might be needed in such patients. |
| doi_str_mv | 10.1002/jmv.25984 |
| format | Article |
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DAA therapy was given to 1438 (663 male, 775 female) patients. Sex differences in the HCC development rate and the factors contributing to HCC development after DAA therapy were investigated. Male patients had a significantly higher cumulative HCC incidence (log‐rank test, P = .007). On multivariate analysis, the fibrosis‐4 index (HR = 1.11; 95%CI, 1.042‐1.202, P = .002) and posttreatment α‐fetoprotein (AFP) (HR = 1.11; 95%CI, 1.046‐1.197, P = .001) were found to be independent factors that contributed to HCC development following DAA therapy in female patients, whereas only posttreatment AFP (HR = 1.090; 95%CI, 1.024‐1.160, P = .007) was an independent factor in male patients. The optimal posttreatment AFP cut‐off values were set based on receiver operating characteristic curve analyses. The optimal posttreatment AFP cut‐off value was much higher in females (6.0 ng/mL) than in male (3.5 ng/mL) patients. In conclusion both in male and female patients, posttreatment AFP was an independent predictor of HCC development after DAA therapy. However, the cut‐off values differed between the sexes. In male patients, HCC could be seen in patients with relatively low posttreatment AFP levels; more careful observation might be needed in such patients.</description><identifier>ISSN: 0146-6615</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.25984</identifier><identifier>PMID: 32374470</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; AFP ; Aged ; alpha-Fetoproteins - analysis ; alpha-Fetoproteins - metabolism ; Antiviral agents ; Antiviral Agents - therapeutic use ; Antiviral drugs ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - virology ; cut‐off value ; direct‐acting antiviral ; Female ; Females ; Fibrosis ; Gender aspects ; Gender differences ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - drug therapy ; Hepatocellular carcinoma ; Humans ; Incidence ; Liver cancer ; Liver Neoplasms - epidemiology ; Liver Neoplasms - virology ; Male ; Middle Aged ; Multivariate analysis ; Rank tests ; Retrospective Studies ; Risk Factors ; Sex ; Sex differences ; Sex Factors ; Therapy ; Virology</subject><ispartof>Journal of medical virology, 2020-12, Vol.92 (12), p.3507-3515</ispartof><rights>2020 Wiley Periodicals LLC</rights><rights>2020 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3534-4b8fca9c1b4611d2c04623657f33d050de8ee78105f7351606ade84b843685603</citedby><cites>FETCH-LOGICAL-c3534-4b8fca9c1b4611d2c04623657f33d050de8ee78105f7351606ade84b843685603</cites><orcidid>0000-0003-4117-339X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.25984$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.25984$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32374470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watanabe, Takao</creatorcontrib><creatorcontrib>Tokumoto, Yoshio</creatorcontrib><creatorcontrib>Joko, Kouji</creatorcontrib><creatorcontrib>Michitaka, Kojiro</creatorcontrib><creatorcontrib>Horiike, Norio</creatorcontrib><creatorcontrib>Tanaka, Yoshinori</creatorcontrib><creatorcontrib>Tada, Fujimasa</creatorcontrib><creatorcontrib>Kisaka, Yoshiyasu</creatorcontrib><creatorcontrib>Nakanishi, Seiji</creatorcontrib><creatorcontrib>Yamauchi, Kazuhiko</creatorcontrib><creatorcontrib>Yukimoto, Atsushi</creatorcontrib><creatorcontrib>Nakamura, Yoshiko</creatorcontrib><creatorcontrib>Hirooka, Masashi</creatorcontrib><creatorcontrib>Abe, Masanori</creatorcontrib><creatorcontrib>Hiasa, Yoichi</creatorcontrib><title>Sex difference in the development of hepatocellular carcinoma after direct‐acting antiviral therapy in patients with HCV infection</title><title>Journal of medical virology</title><addtitle>J Med Virol</addtitle><description>Sex differences in the predictors for hepatocellular carcinoma (HCC) development after direct‐acting antiviral (DAA) therapy was investigated. DAA therapy was given to 1438 (663 male, 775 female) patients. Sex differences in the HCC development rate and the factors contributing to HCC development after DAA therapy were investigated. Male patients had a significantly higher cumulative HCC incidence (log‐rank test, P = .007). On multivariate analysis, the fibrosis‐4 index (HR = 1.11; 95%CI, 1.042‐1.202, P = .002) and posttreatment α‐fetoprotein (AFP) (HR = 1.11; 95%CI, 1.046‐1.197, P = .001) were found to be independent factors that contributed to HCC development following DAA therapy in female patients, whereas only posttreatment AFP (HR = 1.090; 95%CI, 1.024‐1.160, P = .007) was an independent factor in male patients. The optimal posttreatment AFP cut‐off values were set based on receiver operating characteristic curve analyses. The optimal posttreatment AFP cut‐off value was much higher in females (6.0 ng/mL) than in male (3.5 ng/mL) patients. In conclusion both in male and female patients, posttreatment AFP was an independent predictor of HCC development after DAA therapy. However, the cut‐off values differed between the sexes. In male patients, HCC could be seen in patients with relatively low posttreatment AFP levels; more careful observation might be needed in such patients.</description><subject>Adult</subject><subject>AFP</subject><subject>Aged</subject><subject>alpha-Fetoproteins - analysis</subject><subject>alpha-Fetoproteins - metabolism</subject><subject>Antiviral agents</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Antiviral drugs</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - virology</subject><subject>cut‐off value</subject><subject>direct‐acting antiviral</subject><subject>Female</subject><subject>Females</subject><subject>Fibrosis</subject><subject>Gender aspects</subject><subject>Gender differences</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - drug therapy</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Incidence</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - virology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Rank tests</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sex</subject><subject>Sex differences</subject><subject>Sex Factors</subject><subject>Therapy</subject><subject>Virology</subject><issn>0146-6615</issn><issn>1096-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAURi0EokNhwQsgS2xgkdb_SZZoBBRUxALo1vI414xHiR0cZ8rsWPQB-ow8CQ5TWCCxsnR1vqPr-yH0lJIzSgg73w37MybbRtxDK0paVbWkpvfRilChKqWoPEGPpmlHCGlaxh6iE854LURNVujmE3zHnXcOEgQL2Aect4A72EMfxwFCxtHhLYwmRwt9P_cmYWuS9SEOBhuXIZV8Apt__rg1NvvwFZuQ_d4n0y-uZMbDoi0GX3QTvvZ5iy_WV2XoSszH8Bg9cKaf4Mnde4q-vHn9eX1RXX58-2796rKyXHJRiU3jrGkt3QhFaccsEYpxJWvHeUck6aABqBtKpKu5pIooU0YlJbhqpCL8FL04escUv80wZT34afmVCRDnSTPetkwuVyvo83_QXZxTKNtpJmRdi7qVC_XySNkUpymB02Pyg0kHTYleqtGlGv27msI-uzPOmwG6v-SfLgpwfgSufQ-H_5v0-w9XR-UvVneZ2g</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Watanabe, Takao</creator><creator>Tokumoto, Yoshio</creator><creator>Joko, Kouji</creator><creator>Michitaka, Kojiro</creator><creator>Horiike, Norio</creator><creator>Tanaka, Yoshinori</creator><creator>Tada, Fujimasa</creator><creator>Kisaka, Yoshiyasu</creator><creator>Nakanishi, Seiji</creator><creator>Yamauchi, Kazuhiko</creator><creator>Yukimoto, Atsushi</creator><creator>Nakamura, Yoshiko</creator><creator>Hirooka, Masashi</creator><creator>Abe, Masanori</creator><creator>Hiasa, Yoichi</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7TK</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4117-339X</orcidid></search><sort><creationdate>202012</creationdate><title>Sex difference in the development of hepatocellular carcinoma after direct‐acting antiviral therapy in patients with HCV infection</title><author>Watanabe, Takao ; 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DAA therapy was given to 1438 (663 male, 775 female) patients. Sex differences in the HCC development rate and the factors contributing to HCC development after DAA therapy were investigated. Male patients had a significantly higher cumulative HCC incidence (log‐rank test, P = .007). On multivariate analysis, the fibrosis‐4 index (HR = 1.11; 95%CI, 1.042‐1.202, P = .002) and posttreatment α‐fetoprotein (AFP) (HR = 1.11; 95%CI, 1.046‐1.197, P = .001) were found to be independent factors that contributed to HCC development following DAA therapy in female patients, whereas only posttreatment AFP (HR = 1.090; 95%CI, 1.024‐1.160, P = .007) was an independent factor in male patients. The optimal posttreatment AFP cut‐off values were set based on receiver operating characteristic curve analyses. The optimal posttreatment AFP cut‐off value was much higher in females (6.0 ng/mL) than in male (3.5 ng/mL) patients. In conclusion both in male and female patients, posttreatment AFP was an independent predictor of HCC development after DAA therapy. However, the cut‐off values differed between the sexes. In male patients, HCC could be seen in patients with relatively low posttreatment AFP levels; more careful observation might be needed in such patients.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32374470</pmid><doi>10.1002/jmv.25984</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4117-339X</orcidid></addata></record> |
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| subjects | Adult AFP Aged alpha-Fetoproteins - analysis alpha-Fetoproteins - metabolism Antiviral agents Antiviral Agents - therapeutic use Antiviral drugs Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - virology cut‐off value direct‐acting antiviral Female Females Fibrosis Gender aspects Gender differences Hepatitis C, Chronic - complications Hepatitis C, Chronic - drug therapy Hepatocellular carcinoma Humans Incidence Liver cancer Liver Neoplasms - epidemiology Liver Neoplasms - virology Male Middle Aged Multivariate analysis Rank tests Retrospective Studies Risk Factors Sex Sex differences Sex Factors Therapy Virology |
| title | Sex difference in the development of hepatocellular carcinoma after direct‐acting antiviral therapy in patients with HCV infection |
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