Key result
Baseline serum Ang2 level ≥ 464 pg/mL was significantly associated with hepatocellular carcinoma occurrence after direct-acting antiviral therapy (HR 2.75; 95% CI 1.18-6.37; p=0.019).
Why the study?
Progressive liver fibrosis post-anti-HCV treatment increases HCC risk and Ang2 is linked to non-regression of fibrosis, motivating evaluation of serum Ang2 to predict HCC occurrence or recurrence after DAA therapy.
Does serum Angiopoietin-2 level predict HCC occurrence and recurrence in HCV-infected patients treated with DAAs?
Cohort (n=310)
Does serum Angiopoietin-2 level predict HCC occurrence and recurrence in HCV-infected patients treated with DAAs?
Hazard Ratio: 2.75 (95% CI 1.18–6.37)
p-value: p=0.019
Serum Angiopoietin-2 levels can predict the occurrence and recurrence of hepatocellular carcinoma in patients who achieved sustained virological response after direct-acting antiviral therapy for Hepatitis C.
Serum Ang2 may identify higher post-DAA HCC risk in HCV patients; hypothesis-generating and requires prospective validation.
Progressive liver fibrosis after anti-HCV treatment is a risk factor for HCC. Angiopoietin-2 (Ang2) is associated with non-regression of liver fibrosis after direct-acting antiviral (DAA). This study evaluated the predictive value of serum Ang2 levels for HCC occurrence or recurrence after DAA administration. In this retrospective study, 310 HCV-infected patients treated with DAAs in 2014–2020 were screened and evaluated for HCC occurrence or recurrence every three–six months. Multivariate Cox regression analysis revealed that age ≥ 75 years (HR: 2.92, 95% CI: 1.34–6.33; p = 0.007) and baseline Ang2 level ≥ 464 pg/mL (HR: 2.75, 95% CI: 1.18–6.37; p = 0.019) were significantly associated with HCC occurrence after DAA therapy. A high or low risk of HCC after DAA therapy could be distinguished by the combination of age and baseline Ang2 level. The cumulative incidences of de-novo HCC at two and four years were 0.8% and 3.8% in the low-risk group and 22.6% and 27.1% in the high-risk group, respectively. Baseline Ang2 level ≥ 402 pg/mL was significantly associated with HCC recurrence in patients who achieved sustained virological response with DAAs (HR: 3.68). In conclusion, serum Ang2 levels can predict HCC occurrence and recurrence after successful HCV eradication by DAAs.
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Kawagishi et al. (2023) conducted a cohort in Hepatitis C (HCV) infection post-DAA therapy (n=310). Baseline serum Ang2 level ≥ 464 pg/mL vs. Baseline serum Ang2 level < 464 pg/mL was evaluated on HCC occurrence after DAA therapy (HR 2.75, 95% CI 1.18-6.37, p=0.019). Baseline serum Ang2 level ≥ 464 pg/mL was significantly associated with hepatocellular carcinoma occurrence after direct-acting antiviral therapy (HR 2.75; 95% CI 1.18-6.37; p=0.019).
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