{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:09:08Z","timestamp":1773853748305,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The pathogenic process underlying the development of hepatocellular carcinoma (HCC) is not yet clear in patients with chronic hepatitis\u00a0C virus who receive direct\u2010acting antiviral therapy and achieve sustained virological response. This study investigated two risk factors for HCC in these patients; specifically, hepatic fibrosis and steatosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 355 patients in whom hepatitis\u00a0C virus was eradicated by direct\u2010acting antiviral were evaluated. Fibrosis and steatosis were assessed using transient elastography (TE) and the controlled attenuation parameter (CAP). Inverse probability weighting was applied to patient age, sex, albumin\u2013bilirubin, <jats:italic>\u03b1<\/jats:italic>\u2010fetoprotein, history of HCC, TE, or CAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 12\u2010, 24\u2010, and 36\u2010month cumulative incidence rates of HCC were 0.9%, 2.4%, and 4.1%, respectively. Univariate analysis with the Cox proportional hazards model showed that whereas a high TE value (\u226510\u00a0kPa) was significantly associated with HCC development (HR 7.861, 95% CI 2.126\u201329.070; p\u00a0=\u00a00.002), CAP was not. Additionally, univariate analysis with the Cox proportional hazards model adjusted by inverse probability weighting showed that a high TE value was significantly associated with HCC development (HR 3.980, 95% CI, 1.036\u201315.290; p\u00a0=\u00a00.044), whereas CAP was not. The cumulative inverse probability weighting\u2010adjusted incidence of HCC rates at 12, 24, and 36\u00a0months were 0.0%, 0.5%, and 1.7%, respectively, in patients with a low TE value, and 2.5%, 5.1%, and 7.6%, respectively, in those with a high TE value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A high TE value was a risk factor for HCC in hepatitis\u00a0C virus patients who received direct\u2010acting antiviral therapy and achieved sustained virological response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13677","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T02:19:59Z","timestamp":1622168399000},"page":"860-869","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Association of liver stiffness and steatosis with hepatocellular carcinoma development in patients with hepatitis\u00a0C virus infection who received direct\u2010acting antiviral therapy and achieved sustained virological response"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0976-6761","authenticated-orcid":false,"given":"Toshifumi","family":"Tada","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Japanese Red Cross Society Himeji Hospital  Himeji Hyogo Japan"},{"name":"Department of Internal Medicine Division of Gastroenterology and Hepatology Hyogo College of Medicine  Nishinomiya Hyogo Japan"},{"name":"Ultrasound Imaging Center Hyogo College of Medicine  Nishinomiya Hyogo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Division of Gastroenterology and Hepatology Hyogo College of Medicine  Nishinomiya Hyogo Japan"},{"name":"Ultrasound Imaging Center Hyogo College of Medicine  Nishinomiya Hyogo 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