Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication: A systematic review and meta-analysis

ARTICLE HIGHLIGHTS

Research background

Direct-acting antiviral agents (DAAs) modified the natural history of chronic hepatitis C. However, despite the advancements in sustained virologic response (SVR), some patients remain at risk of developing hepatocellular carcinoma (HCC). In this context, liver stiffness (LS) measurement could serve as a predictor of HCC, allowing for the identification of patients at higher risk.

Research motivation

Identification of SVR patients at higher risk of HCC development could enhance follow-up timing and improve early diagnosis and overall prognosis.

Research objectives

The aim of this meta-analysis is to investigate shear-wave elastography (SWE) as a predictor of HCC occurrence after hepatitis C virus (HCV) clearance with DAAs.

Research methods

We conducted a systematic literature review and planned a qualitative and quantitative synthesis of the evidence through analysis of the Hedges’ g standardized difference of the LS means in those who developed HCC and those who did not. The absence of a predefined LS cut-off prevented us from deriving the effect measures (i.e. hazard ratio or odds ratio).

Research results

LS at baseline and 12 wk follow-up showed a trend towards greater values in those who will develop HCC compared to those who will not [baseline LS standardized mean difference (SMD): 1.15, 95% confidence interval (95%CI): 020-2.50; LS SMD after 12 wk: 0.83, 95%CI: 0.33-1.98]. The standardized mean difference between LS in the two groups at 24 wk follow-up was statistically significant (0.64; 95%CI: 0.04-1.24).

Research conclusions

This study explored the ability of SWE to predict HCC after HCV eradication.

Research perspectives

LS, measured by SWE, looks a promising predictor of HCC occurrence in SVR patients. These results need to be further confirmed by larger cohorts.