Serum Agalactosyl IgG Predicts Hepatocellular Carcinoma and All-Cause Mortality After SVR in Advanced Chronic Hepatitis C
In brief
Higher end-of-treatment agalactosyl IgG raises HCC risk by 5% and mortality by 9%
In 136 patients with advanced hepatitis C who achieved SVR, each unit increase in serum agalactosyl IgG measured at the end of DAA therapy was linked to a 5% higher chance of developing hepatocellular carcinoma and a 9% higher chance of all-cause death, independent of age, sex and baseline fibrosis. This marker could help clinicians flag those needing closer post-SVR surveillance, though validation in larger cohorts is needed.
- Journal
- Hepatology research : the official journal of the Japan Society of Hepatology (Q1)
- Published
- 2 August 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Daisuke Sakon, Jumpei Kondo, Yuki Tahata, Hayato Hikita, Maki Iwaisako, Muya Matsumoto, et al.
- PMID
- 42543016
- DOI
- 10.1111/hepr.70255
Why clinicians should know about it
- Picked for Epidemiology (paper of the day, 3 August 2026): Biomarker prognostic study in ADHF, not population burden
Abstract
BACKGROUND AND AIMS: Patients with chronic hepatitis C and advanced fibrosis remain at substantial risk of hepatocellular carcinoma (HCC) and non-liver-related death even after sustained virological response (SVR) to direct-acting antivirals (DAA). Serum agalactosyl IgG (agal-IgG) reflects chronic inflammation and fibrogenic activity, but its prognostic value after SVR is unknown. We investigated whether serum agal-IgG at end of treatment (EOT) predicts HCC and all-cause mortality in DAA-treated patients with advanced fibrosis. METHODS: Among 3550 patients with chronic hepatitis C treated with DAAs at Osaka University Hospital and affiliated centers, the stored sera of 136 patients with biopsy-proven F3-F4 fibrosis before DAA treatment, who achieved SVR, and had no history of HCC were available at EOT. Serum agal-IgG at EOT was measured using a 42B1-based ELISA. RESULTS: During a median follow-up of 68.7 months (interquartile range, 36.8-84.9) for HCC surveillance, 15 patients developed HCC. Over a median overall follow-up of 73.7 months (54.5-86.7), 11 patients died. Higher EOT agal-IgG levels were significantly associated with both HCC occurrence and all-cause mortality, and these associations remained independent after adjustment for age, sex, and baseline fibrosis (FIB-4 index). The adjusted hazard ratios per 1-unit increase in agal-IgG were 1.050 (95% CI, 1.008-1.094) for HCC and 1.085 (95% CI, 1.035-1.137) for all-cause mortality. Patients with EOT agal-IgG levels above the cohort median also showed significantly higher cumulative incidences of HCC and all-cause death than those with lower levels. CONCLUSIONS: Serum agalactosyl IgG measured at the end of DAA therapy independently predicts HCC and all-cause mortality after SVR in patients with chronic hepatitis C and advanced fibrosis. EOT agal-IgG may offer additional prognostic information for post-SVR risk stratification and help identify patients at higher risk of HCC and all-cause mortality after SVR.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.