Abstracts of the 2024 Annual Meeting of the ALEH
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Introduction and ObjectivesHepatitis C virus (HCV) still is the leading cause of hepatocellular carcinoma (HCC) in Brazil, even after the new treatments with DAAs. HCC surveillance is recommended based on liver fibrosis, whereby patients with advanced fibrosis are suitable for screening. Therefore, there is a need for tools to improve risk stratification in this population. Our aim was to assess whether the ALBI score performed at first evaluation of patients with HCV-related cirrhosis could stratify the risk of developing HCC.
Patients / Materials and MethodsThis study included 108 patients with HCV-related cirrhosis evaluated in the outpatient units in Hospital de Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. Clinical data from the first evaluation and ALBI score with first the laboratory tests were used for the statistical analysis. The last follow-up was at the last HCC screening image in patients who did not develop HCC and at HCC diagnosis in those who did. The statistical analyses were performed using Jamovi software version 2.3.23.
Results and DiscussionDuring follow-up, with a mean duration of 5.28 ± 4.72 years, 32 patients developed HCC. Patients who developed HCC had significantly lower albumin values (p=0.039) and a higher proportion of ALBI grade 2 (p=0.036) at the first outpatient assessment. Evaluating HCC risk over time by Kaplan-Meier, patients with ALBI grade 2 had a significantly higher risk of developing HCC than patients with ALBI grade 1 (p=0.019) when assessed at 1 year (17% vs. 8.2%), 2 years (29.3% vs. 15.4%), 5 years (40.9% vs. 21.4%) and 10 years (47.4% vs. 23.9%). Patients with ALBI grade 2 had a two-fold higher risk of developing HCC during follow-up (OR 2.27, 95%CI 1.12-4.59, p=0.023).
ConclusionsAssessment of baseline ALBI score can improve HCC risk stratification in patients with HCV-related cirrhosis.
