Speaker Biography

Dr. Abdelaleem Helal
Biography:

Abdelaleem Helal has his expertise in viral hepatitis and HCC from his Prof. Dr. Mohamed Akl and colleges in  Department of Hepatology and Gastroenterology, National Liver Institute, ‎ Menofia University, Shebeen El-Kom, Egypt.

Abstract:

Background: Hepatocellular carcinoma is a common health burden in cirrhotic patients with HCV infection. ‎New direct-acting antivirals substantially improved the cure rate to above 90%. Moreover, cancer risk ‎persists even after 10 years of viral cure.

Aim: To evaluate Transient Elastography as predictor of HCC after Direct acting antiviral drugs (DAAs).‎

Methods: All patients with HCV related fibrosis who did FibroScanTM before treatment with DAAs were ‎included retrospectively. Liver, renal function tests, CBC, INR, alpha-fetoprotien, abdominal ‎ultrasonography, Triphasic CT, and FibroScanTM were performed at the National Liver Institute, Menofia ‎University from January 2015 to December 2016. Patients who had a Transient Elastography measurement ‎before treatment with DAAs were included and divided into two groups; Group (I) patients who developed ‎De novo HCC and Group (II) are those who did not developed HCC after DAAs.‎

Results: Patients who developed de novo HCC after DAAs (group I, thirty patients) had higher serum AST ‎levels (68.3 ± 38.2 vs. 48.7 ± 32.4 U/L), lower platelet count (131.5 ± 55.6 vs. 179.5 ± 69.8 ×103 /µL) and ‎older age (59.5±6.4 vs. 51.3±10.5 years) than patients who did not developed HCC (group II, ninety ‎patients) with a p value <0.05.  Group I patients had a statistically significant higher liver stiffness ‎measurement (LSM) by FibroscanTM (32.1 ± 10.7 vs 15.5± 11.5 kPa, p value = 0.001) than patients who did ‎not developed HCC. With a cutoff of 18.5 kPa  being the most predictive value of de novo HCC ‎development  after treatment of chronic HCV infection with DAAs (90.0% sensitivity, 80.0% specificity, ‎‎55.0% PPV, 97.3% NPV, 80.0% accuracy) as shown in figure 1.‎

Conclusion: The measurement of liver stiffness by FibroScanTM could be a reliable method for risk ‎stratification and prediction of de novo HCC development after DAAs in cirrhotic patients.‎