Prothrombin induced by vitamin K absence or antagonist‐II and alpha foetoprotein to predict development of hepatocellular carcinoma in Caucasian patients with hepatitis C‐related cirrhosis treated with direct‐acting antiviral agents

Summary Background Prothrombin induced by vitamin K absence or antagonist‐II (PIVKA‐II) and alpha fetoprotein (AFP) are biomarkers for hepatocellular carcinoma (HCC). However, their performance in patients with cirrhosis related to hepatitis C virus (HCV) treated with direct‐acting antiviral agents (DAA) is unknown. Aim To evaluate PIVKA‐II and AFP as HCC predictors in DAA‐treated patients with HCV‐related cirrhosis Methods In this single centre study, patients with cirrhosis from chronic HCV infection and with a sustained virological response (SVR) to DAA were tested for PIVKA‐II and AFP (Fujirebio, Japan) at the start of DAA treatment (baseline), end of treatment (EOT) and at HCC diagnosis. Results We included 400 patients with mean age 65 (24‐92); 56% were men. From baseline to EOT, PIVKA‐II did not change (35 vs 35 mAU/mL, P = 0.43) while AFP significantly decreased (12 vs 6 ng/mL, P