Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis

Background: Hepatitis C virus (HCV)-infected patients treated with direct-acting antivirals (DAAs) are still at risk of developing hepatocellular carcinoma (HCC) after sustained virologic response (SVR). This study aimed to investigate the role of diabetes mellitus (DM) as a potential predictive ris...

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Autores principales: Váncsa, Szilárd, Németh, Dávid, Hegyi, Péter, Szakács, Zsolt, Farkas, Ádám, Kiss, Szabolcs, Hegyi, Péter Jenő, Kanjo, Anna, Sarlós, Patrícia, Erőss, Bálint, Pár, Gabriella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558240/
https://www.ncbi.nlm.nih.gov/pubmed/34733865
http://dx.doi.org/10.3389/fmed.2021.744512
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author Váncsa, Szilárd
Németh, Dávid
Hegyi, Péter
Szakács, Zsolt
Farkas, Ádám
Kiss, Szabolcs
Hegyi, Péter Jenő
Kanjo, Anna
Sarlós, Patrícia
Erőss, Bálint
Pár, Gabriella
author_facet Váncsa, Szilárd
Németh, Dávid
Hegyi, Péter
Szakács, Zsolt
Farkas, Ádám
Kiss, Szabolcs
Hegyi, Péter Jenő
Kanjo, Anna
Sarlós, Patrícia
Erőss, Bálint
Pár, Gabriella
author_sort Váncsa, Szilárd
collection PubMed
description Background: Hepatitis C virus (HCV)-infected patients treated with direct-acting antivirals (DAAs) are still at risk of developing hepatocellular carcinoma (HCC) after sustained virologic response (SVR). This study aimed to investigate the role of diabetes mellitus (DM) as a potential predictive risk factor in developing de novo HCC in HCV-infected patients after DAA treatment. Methods: This study was registered on PROSPERO under registration number CRD42021230457. We performed a systematic search in four medical databases from inception through November 3rd, 2020. Studies were eligible if they reported on HCV-infected patients treated with DAAs and compared the frequency of de novo HCC in patients with and without DM. We calculated pooled odds ratios, unadjusted (UHR), and adjusted hazard ratios (AHR) with 95% confidence intervals (CIs) in meta-analysis. Results: We included 30 articles in our systematic review and meta-analysis. DM proved to be a significant risk factor of HCC in DAA-treated HCV patients in unadjusted (UHR = 1.44, CI: 1.15–1.79) and adjusted analyses (AHR = 1.31, CI: 1.06–1.62). In the group of patients achieving SVR after DAA therapy, DM increased the risk of HCC in unadjusted (UHR = 1.3, CI: 1.09–1.51) analysis; however, in adjusted results, the risk was non-significant (AHR = 1.07, CI: 0.89–1.28). In patients with advanced liver fibrosis, DM was a risk factor for HCC in adjusted (AHR = 1.36, CI: 1.03–1.8), but not in unadjusted analysis (UHR = 1.11, CI: 0.8–1.42). Conclusions: DM is an independent risk factor of de novo HCC after DAA treatment in HCV-infected patients. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=230457, identifier: CRD42021230457.
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spelling pubmed-85582402021-11-02 Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis Váncsa, Szilárd Németh, Dávid Hegyi, Péter Szakács, Zsolt Farkas, Ádám Kiss, Szabolcs Hegyi, Péter Jenő Kanjo, Anna Sarlós, Patrícia Erőss, Bálint Pár, Gabriella Front Med (Lausanne) Medicine Background: Hepatitis C virus (HCV)-infected patients treated with direct-acting antivirals (DAAs) are still at risk of developing hepatocellular carcinoma (HCC) after sustained virologic response (SVR). This study aimed to investigate the role of diabetes mellitus (DM) as a potential predictive risk factor in developing de novo HCC in HCV-infected patients after DAA treatment. Methods: This study was registered on PROSPERO under registration number CRD42021230457. We performed a systematic search in four medical databases from inception through November 3rd, 2020. Studies were eligible if they reported on HCV-infected patients treated with DAAs and compared the frequency of de novo HCC in patients with and without DM. We calculated pooled odds ratios, unadjusted (UHR), and adjusted hazard ratios (AHR) with 95% confidence intervals (CIs) in meta-analysis. Results: We included 30 articles in our systematic review and meta-analysis. DM proved to be a significant risk factor of HCC in DAA-treated HCV patients in unadjusted (UHR = 1.44, CI: 1.15–1.79) and adjusted analyses (AHR = 1.31, CI: 1.06–1.62). In the group of patients achieving SVR after DAA therapy, DM increased the risk of HCC in unadjusted (UHR = 1.3, CI: 1.09–1.51) analysis; however, in adjusted results, the risk was non-significant (AHR = 1.07, CI: 0.89–1.28). In patients with advanced liver fibrosis, DM was a risk factor for HCC in adjusted (AHR = 1.36, CI: 1.03–1.8), but not in unadjusted analysis (UHR = 1.11, CI: 0.8–1.42). Conclusions: DM is an independent risk factor of de novo HCC after DAA treatment in HCV-infected patients. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=230457, identifier: CRD42021230457. Frontiers Media S.A. 2021-10-18 /pmc/articles/PMC8558240/ /pubmed/34733865 http://dx.doi.org/10.3389/fmed.2021.744512 Text en Copyright © 2021 Váncsa, Németh, Hegyi, Szakács, Farkas, Kiss, Hegyi, Kanjo, Sarlós, Erőss and Pár. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Váncsa, Szilárd
Németh, Dávid
Hegyi, Péter
Szakács, Zsolt
Farkas, Ádám
Kiss, Szabolcs
Hegyi, Péter Jenő
Kanjo, Anna
Sarlós, Patrícia
Erőss, Bálint
Pár, Gabriella
Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis
title Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis
title_full Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis
title_fullStr Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis
title_full_unstemmed Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis
title_short Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis
title_sort diabetes mellitus increases the risk of hepatocellular carcinoma after direct-acting antiviral therapy: systematic review and meta-analysis
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558240/
https://www.ncbi.nlm.nih.gov/pubmed/34733865
http://dx.doi.org/10.3389/fmed.2021.744512
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