title: Liver fibrosis indices for identifying patients at low risk of developing hepatocellular carcinoma after eradication of HCV.
abstract: Hepatocellular carcinoma (HCC) in patients with chronic hepatitis C can develop after sustained virological response (SVR) to antiviral therapy for HCV, that is, the eradication of HCV, and effective surveillance systems for HCC should be established for this population. We retrospectively evaluated the utility of three laboratory liver fibrosis indices (aspartate aminotransferase-platelet ratio index [APRI], FIB-4 index and Forns index) for identifying patients at low risk of HCC development after SVR, for whom the termination of surveillance for HCC can be considered.
  
  
  
  APRI, FIB-4 index and Forns index scores were calculated based on laboratory data prior to anti-HCV therapy and at 24 weeks after the end of anti-HCV therapy (SVR24) in 522 patients with SVR who continued surveillance for HCC after SVR. The associations between HCC development and laboratory indices at both points were analysed.
  
  
  
  Twenty-one patients developed HCC after SVR during 2.3-24.4 years follow-up. Whereas HCC developed even in patients with low APRI or FIB-4 index scores, no patients with low Forns index scores developed HCC after SVR. These results were confirmed in a separate cohort of 309 patients who achieved SVR (HCC developed in 17 patients during 1.7-21.6 years follow-up).
  
  
  
  Forns index, especially assessed prior to anti-HCV therapy, was a useful laboratory liver fibrosis index for identifying patients at low likelihood of HCC after SVR. This index may be used as one of indicators to consider the termination of surveillance for HCC after the eradication of HCV.
authors: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Hidenori
authors: H
authors: Toyoda
authors: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Toshifumi
authors: T
authors: Tada
authors: Department of Gastroenterology, Komaki City Hospital, Komaki, Japan.
authors: Yoshihiko
authors: Y
authors: Tachi
authors: Department of Gastroenterology, Komaki City Hospital, Komaki, Japan.
authors: Takanori
authors: T
authors: Hirai
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Satoshi
authors: S
authors: Yasuda
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Takashi
authors: T
authors: Honda
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Kazuhiko
authors: K
authors: Hayashi
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Masatoshi
authors: M
authors: Ishigami
authors: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Hidemi
authors: H
authors: Goto
authors: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
authors: Takashi
authors: T
authors: Kumada
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012306:Risk; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers