High Post-treatment α-Fetoprotein Levels and Aspartate Aminotransferase-to-Platelet Ratio Index Predict Hepatocellular Carcinoma in Hepatitis C Virus Decompensated Cirrhotic Patients with Sustained Virological Response after Antiviral Therapy

Although eradication of hepatitis C virus (HCV) decreases the risk of hepatocellular carcinoma (HCC) development, a considerable level of risk remains in cirrhotic patients with advanced liver disease. Yet, data for the effect of serum markers on HCC development in this population after viral eradication are still lacking. Seventy-eight consecutive patients with HCV infection and decompensated cirrhosis were administered interferon-based regimens at our hospital between August 2008 and December 2013. Thirty-four achieved sustained virological response and were enrolled in the study. Occurrence of HCC was evaluated every 3-6 months post-treatment. The mean age of the 34 patients was 55.7 ± 8.3 years (range: 39-70) old. Compared with baseline, at 24 weeks post-treatment the serum levels were significantly decreased for α-fetoprotein (AFP) (12.20 ± 4.12 versus 8.37 ± 2.75 ng/mL, P < 0.001), aspartate aminotransferase (AST) (58.44 ± 15.12 versus 36.59 ± 11.22 IU/L, P < 0.001), and AST-to-platelet ratio index (APRI) (2.21 ± 0.74 versus 1.35 ± 0.61, P < 0.001) but significantly increased for platelet count (69.65 ± 17.46 versus 73.65 ± 18.0 × 10³/μL, P = 0.022). Median follow-up time was 41.4 ± 16.8 (range: 9-71) months, and 5 patients (14.7%) developed HCC. Post-treatment APRI ≥1.5 and AFP ≥10 ng/mL were associated with HCC development (both P < 0.01). Post-treatment AFP and APRI maybe are useful markers to further classify HCC risk in HCV-decompensated cirrhotic patients after viral eradication.