Abstract：
BACKGROUND: Chronic HC leads to the development of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). The treatment of chronic HC with DAAs reduces mortality from LC and HCC. The study aimed to investigate the serological markers specific to HCC (PIVKA-II and AFP) in patients with chronic HC before and after DAA treatment.
METHODS: The study involved 35 HCV patients (mean age: 56.23 ± 1.45) divided into two groups. Group 1 included 15 HCV + HCC patients and Group 2 included 20 HCV non-HCC patients.
RESULTS: At the end of treatment all the patients were HCV RNA negative. Three months after the end of antiviral treatment, HCV RNA was undetectable in all patients, while a complete biochemical and virological response was observed in 66.7% of HCV + HCC patients and 85.0% of HCV non-HCC patients. PIVKA-II levels before the initiation of antiviral treatment were high in all patients. At the end of the treatment, in the HCV non-HCC group, normalization of PIVKA-II levels was observed only in 20.0% cases, and in 60.0% of cases 3 months after the treatment. Meanwhile, in patients with HCC and chronic HCV, PIVKA-II levels were within the normal range 3 months after treatment in only 13.3% of patients.
CONCLUSIONS: It is necessary to monitor HCV patients with cirrhosis (F4) and severe fibrosis (F3) without HCC, who have high PIVKA-II and AFP levels and/or ALT activity despite obtaining sustained virologic response 3 months after treatment with DAAs.
METHODS: The study involved 35 HCV patients (mean age: 56.23 ± 1.45) divided into two groups. Group 1 included 15 HCV + HCC patients and Group 2 included 20 HCV non-HCC patients.
RESULTS: At the end of treatment all the patients were HCV RNA negative. Three months after the end of antiviral treatment, HCV RNA was undetectable in all patients, while a complete biochemical and virological response was observed in 66.7% of HCV + HCC patients and 85.0% of HCV non-HCC patients. PIVKA-II levels before the initiation of antiviral treatment were high in all patients. At the end of the treatment, in the HCV non-HCC group, normalization of PIVKA-II levels was observed only in 20.0% cases, and in 60.0% of cases 3 months after the treatment. Meanwhile, in patients with HCC and chronic HCV, PIVKA-II levels were within the normal range 3 months after treatment in only 13.3% of patients.
CONCLUSIONS: It is necessary to monitor HCV patients with cirrhosis (F4) and severe fibrosis (F3) without HCC, who have high PIVKA-II and AFP levels and/or ALT activity despite obtaining sustained virologic response 3 months after treatment with DAAs.
摘要：
背景：慢性HC导致肝硬化（LC）和肝细胞癌（HCC）的发展。用DAA治疗慢性HC可降低LC和HCC的死亡率。该研究旨在调查DAA治疗前后慢性HC患者的HCC特异性血清学标志物（PIVKA-II和AFP）。
方法：本研究涉及35例HCV患者（平均年龄：56.23±1.45），分为两组。第1组包括15名HCV+HCC患者，第2组包括20名HCV非HCC患者。
结果：治疗结束时，所有患者均为HCVRNA阴性。抗病毒治疗结束三个月后，所有患者都检测不到HCVRNA，而在66.7%的HCV+HCC患者和85.0%的HCV非HCC患者中观察到完整的生化和病毒学应答。在开始抗病毒治疗之前，所有患者的PIVKA-II水平都很高。在治疗结束时,在HCV非HCC组中，仅在20.0%的病例中观察到PIVKA-II水平正常化，60.0%的病例在治疗后3个月。同时,在HCC和慢性HCV患者中，仅13.3%的患者在治疗后3个月PIVKA-II水平在正常范围内。
结论：有必要监测无HCC的肝硬化（F4）和严重纤维化（F3）的HCV患者，尽管在使用DAA治疗3个月后获得持续的病毒学应答，但仍具有较高的PIVKA-II和AFP水平和/或ALT活性。
方法：本研究涉及35例HCV患者（平均年龄：56.23±1.45），分为两组。第1组包括15名HCV+HCC患者，第2组包括20名HCV非HCC患者。
结果：治疗结束时，所有患者均为HCVRNA阴性。抗病毒治疗结束三个月后，所有患者都检测不到HCVRNA，而在66.7%的HCV+HCC患者和85.0%的HCV非HCC患者中观察到完整的生化和病毒学应答。在开始抗病毒治疗之前，所有患者的PIVKA-II水平都很高。在治疗结束时,在HCV非HCC组中，仅在20.0%的病例中观察到PIVKA-II水平正常化，60.0%的病例在治疗后3个月。同时,在HCC和慢性HCV患者中，仅13.3%的患者在治疗后3个月PIVKA-II水平在正常范围内。
结论：有必要监测无HCC的肝硬化（F4）和严重纤维化（F3）的HCV患者，尽管在使用DAA治疗3个月后获得持续的病毒学应答，但仍具有较高的PIVKA-II和AFP水平和/或ALT活性。
