The Role of MASLD in Increasing Liver Cancer Risk Post-HCV Treatment
New research shows MASLD significantly increases the risk of hepatocellular carcinoma after hepatitis C cure. Effective management of metabolic health is crucial for liver cancer prevention post-treatment.
Recent studies have highlighted the significant impact of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) on the development of hepatocellular carcinoma (HCC) even after successful hepatitis C virus (HCV) eradication. MASLD is diagnosed when steatotic liver disease (SLD) coexists with at least one cardiometabolic risk factor (CMRF), such as obesity, hypertension, type 2 diabetes, or dyslipidemia.
A multicenter research effort in Taiwan involving 1,598 participants tracked these individuals for a median of five years after they received direct-acting antivirals (DAAs) to cure HCV. The findings revealed that patients with MASLD faced roughly double the risk of developing HCC compared to those without MASLD, even after accounting for age, sex, liver stiffness, platelet count, liver enzyme levels, and alpha-fetoprotein. The risk remained consistent when considering other causes of mortality, emphasizing the persistent threat posed by MASLD.
Furthermore, nearly all individuals with steatotic liver disease also had MASLD, underscoring the close link between metabolic health and liver disease progression. The study also indicated that MASLD mediates several CMRFs that contribute to carcinogenesis, highlighting its central role in HCC development.
Experts suggest that, although the incidence of HCC tends to decline following viral cure, continued reliance on vigilant screening and management of metabolic risk factors is essential. Lifestyle modifications and effective control of conditions like obesity, diabetes, and hypertension should be prioritized. Additionally, emerging therapies targeting the liver microenvironment, such as thyroid hormone receptor beta (THRβ) agonists, may offer new avenues to reduce HCC risk.
In conclusion, managing MASLD and associated metabolic derangements is vital for reducing liver cancer risk in patients cured of HCV, emphasizing a comprehensive approach that includes lifestyle adjustments and targeted therapies.
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