{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T21:32:07Z","timestamp":1773437527169,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Patients with chronic hepatitis C and stage 3 fibrosis are thought to remain at risk of hepatocellular carcinoma after sustained virological response. We investigated this risk in a large cohort of patients with well\u2010defined stage 3 fibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a multicentre, ambispective, observational study of chronic hepatitis C patients with sustained virological response after treatment with direct\u2010acting antivirals started between January and December 2015. Baseline stage 3 was defined in a two\u2010step procedure: we selected patients with transient elastography values of 9.5\u201014.5\u00a0kPa and subsequently excluded those with nodular liver surface, splenomegaly, ascites or collaterals on imaging, thrombopenia or esophago\u2010gastric varices. Patients were screened twice\u2010yearly using ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final sample comprised 506 patients (median age, 57.4\u00a0years; males, 59.9%; diabetes, 17.2%; overweight, 44.1%; genotype 3, 8.9%; HIV coinfection, 18.4%; altered liver values, 15.2%). Median follow\u2010up was 33.7 (22.1\u201039.1) months. Five hepatocellular carcinomas and 1 cholangiocarcinoma were detected after a median of 29.4\u00a0months (95% CI: 26.8\u201039.3), with an incidence of 0.47\/100 patients\/year (95% CI: 0.17\u20101.01). In the multivariate analysis, only males older than 55\u00a0years had a significant higher risk (hazard ratio 7.2 [95% CI: 1.2\u201041.7; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.029]) with an incidence of 1.1\/100 patients\/year (95% CI: 0.3\u20102.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a large, well\u2010defined cohort of patients with baseline hepatitis C stage\u20103 fibrosis, the incidence of primary liver tumours was low after sustained virological response and far from the threshold for cost\u2010effectiveness of screening, except in males older than 55\u00a0years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15032","type":"journal-article","created":{"date-parts":[[2021,8,15]],"date-time":"2021-08-15T16:57:06Z","timestamp":1629046626000},"page":"2885-2891","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Hepatocellular carcinoma risk in hepatitis C stage\u20103 fibrosis after sustained virological response with direct\u2010acting antivirals"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7498-2188","authenticated-orcid":false,"given":"Mar\u00eda","family":"S\u00e1nchez\u2010Azofra","sequence":"first","affiliation":[{"name":"Gastroenterology Department La Paz University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inmaculada","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Gastroenterology Department 12 de Octubre University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda L.","family":"Garc\u00eda\u2010Buey","sequence":"additional","affiliation":[{"name":"Gastroenterology Department La Princesa University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6018-9026","authenticated-orcid":false,"given":"Lourdes","family":"Dom\u00ednguez\u2010Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"HIV Unit Internal Medicine Department 12 de Octubre University Hospital Madrid Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1915-2157","authenticated-orcid":false,"given":"Conrado M.","family":"Fern\u00e1ndez\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n, University Rey Juan Carlos Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Mancebo","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Albacete University Hospital Albacete Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda","family":"Bonet","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Son Espases University Hospital Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Ryan","sequence":"additional","affiliation":[{"name":"HIV Unit Internal Medicine Department Infanta Leonor University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Gea","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Ram\u00f3n y Cajal University Hospital Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"D\u00edaz\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Gastroenterology Department Sureste University Hospital Arganda del Rey 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