Genetics Variants and Serum Levels of MHC Class I Chain-related A in Predicting Hepatocellular Carcinoma Development in Chronic Hepatitis C Patients Post Antiviral Treatment

BACKGROUND/AIMS The genome-wide association study has shown that MHC class I chain-related A (MICA) genetic variants were associated with hepatitis C virus (HCC) related hepatocellular carcinoma. The impact of the genetic variants and its serum levels on post-treatment cohort is elusive. METHODS MICA rs2596542 genotype and serum MICA (sMICA) levels were evaluated in 705 patients receiving antiviral therapy. RESULTS Fifty-eight (8·2%) patients developed HCC, with a median follow-up period of 48·2months (range: 6-129months). The MICA A allele was associated with a significantly increased risk of HCC development in cirrhotic non-SVR patients but not in patients of non-cirrhotic and/or with SVR. For cirrhotic non-SVR patients, high sMICA levels (HR/CI: 5·93/1·86-26.38·61, P=0·002) and the MICA rs2596542 A allele (HR/CI: 4·37/1·52-12·07, P=0·002) were independently associated with HCC development. The risk A allele or GG genotype with sMICA>175ng/mL provided the best accuracy (79%) and a negative predictive value of 100% in predicting HCC. CONCLUSIONS Cirrhotic patients who carry MICA risk alleles and those without risk alleles but with high sMICA levels possessed the highest risk of HCC development once they failed antiviral therapy.