Portal de investigação
Incidence and predictors of hepatocellular carcinoma in patients with autoimmune hepatitis
Autores da FMUP
Participantes de fora da FMUP
- Colapietro, Francesca
- Maisonneuve, Patrick
- Lytvyak, Ellina
- Beuers, Ulrich
- Verdonk, Robert C.
- van der Meer, Adriaan J.
- van Hoek, Bart
- Kuiken, Sjoerd D.
- Brouwer, Johannes T.
- Muratori, Paolo
- Aghemo, Alessio
- Carella, Francesco
- van den Berg, Ad P.
- Zachou, Kalliopi
- Dalekos, George N.
- Di Zeo-Sanchez, Daniel E.
- Robles, Mercedes
- Andrade, Raul J.
- Montano-Loza, Aldo J.
- van den Brand, Floris F.
- Slooter, Charlotte D.
- Liberal, Rodrigo
- de Boer, Ynto S.
- Lleo, Ana
- Dutch AIH Study Grp
- Int Autoimmune Hepatitis Grp
Unidades de investigação
Abstract
Background and Aims: Autoimmune hepatitis (AIH) is a rare chronic liver disease of unknown aetiology; the risk of hepatocellular carcinoma (HCC) remains unclear and risk factors are not well-defined. We aimed to investigate the risk of HCC across a multicentre AIH cohort and to identify predictive factors. Methods: We performed a retrospective, observational, multicentric study of patients included in the International Autoimmune Hepatitis Group Retrospective Registry. The assessed clinical outcomes were HCC development, liver transplantation, and death. Fine and Gray regression analysis stratified by centre was applied to determine the effects of individual covariates; the cumulative incidence of HCC was estimated using the competing risk method with death as a competing risk. Results: A total of 1,428 patients diagnosed with AIH from 1980 to 2020 from 22 eligible centres across Europe and Canada were included, with a median follow-up of 11.1 years (interquartile range 5.2-15.9). Two hundred and ninety-three (20.5%) patients had cirrhosis at diagnosis. During follow-up, 24 patients developed HCC (1.7%), an incidence rate of 1.44 cases/1,000 patient-years; the cumulative incidence of HCC increased over time (0.6% at 5 years, 0.9% at 10 years, 2.7% at 20 years, and 6.6% at 30 years of follow-up). Patients who developed cirrhosis during follow-up had a significantly higher incidence of HCC. The cumulative incidence of HCC was 2.6%, 4.6%, 5.6% and 6.6% at 5, 10, 15, and 20 years after the development of cirrhosis, respectively. Obesity (hazard ratio [HR] 2.94, p = 0.04), cirrhosis (HR 3.17, p = 0.01), and AIH/PSC variant syndrome (HR 5.18, p = 0.007) at baseline were independent risk factors for HCC development. Conclusions: HCC incidence in AIH is low even after cirrhosis development and is associated with risk factors including obesity, cirrhosis, and AIH/PSC variant syndrome.
Dados da publicação
- ISSN/ISSNe:
- 1600-0641, 0168-8278
- Tipo:
- Article
- Páginas:
- 53-61
- Link para outro recurso:
- www.scopus.com
Journal of Hepatology Elsevier
Citações Recebidas na Web of Science: 17
Citações Recebidas na Scopus: 15
Documentos
- Não há documentos
Filiações
Keywords
- <span style=''background-color: inherit;''>Autoimmune Hepatitis</span>; <span style=''background-color: inherit;''>Hepatocellular carcinoma</span>; <span style=''background-color: inherit;''></span><span style=''background-color: inherit;''> </span><span style=''background-color: inherit;''>Liver cancer</span>; <span style=''background-color: inherit;''></span><span style=''background-color: inherit;''> </span><span style=''background-color: inherit;''>Immunosuppressive therapy</span>
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Citar a publicação
Colapietro F,Maisonneuve P,Lytvyak E,Beuers U,Verdonk RC,van der Meer AJ,van B,Kuiken SD,Brouwer JT,Muratori P,Aghemo A,Carella F,van den Berg A,Zachou K,Dalekos GN,Di Zeo DE,Robles M,Andrade RJ,Montano AJ,van den Brand FF,Slooter CD,Macedo G,Liberal R,de Boer YS,Lleo A,Dutch AIH Study GRP,Int Autoimmune Hepatitis GRP. Incidence and predictors of hepatocellular carcinoma in patients with autoimmune hepatitis. J. Hepatol. 2024. 80. (1):p. 53-61. IF:25,700. (1).
