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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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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. |
format | Online Article Text |
id | pubmed-8558240 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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