lnc‐HOTAIR predicts hepatocellular carcinoma in chronic hepatitis C genotype 4 following direct‐acting antivirals therapy

Emerging hepatocellular carcinoma (HCC) has been sequentially reported in chronic
hepatitis C virus (HCV) treated with direct‐acting antivirals (DAAs). Homeobox
transcript antisense RNA (HOTAIR), an oncogene, has been reported to be associated
with cancer. We investigated the predictive value of lnc‐HOTAIR for HCC surveillance in chronic HCV patients following DAAs therapy. The expression levels of lnc‐
HOTAIR and ATG‐7 genes were measured in 220 with chronic HCV, following a
DAAs based therapy for 12 weeks, the patients were followed‐up for attentive
surveillance of HCC for 12 months after starting DAAs. In terms of lnc‐HOTAIR,
patients with HCC and high viral load had significantly higher median expression
levels of HOTAIR of (68 vs. 24; p = .001) and (94 vs. 52; p = .001), respectively.
Moreover, the median expression level of ATG‐7 was higher in those who developed
HCC (114 vs. 51; p = .001). The expression of lnc‐HOTAIR and ATG‐7 are significant
predictors of the development of HCC in HCV‐4 infected patients treated with
DAAs, with a cut‐off value of 37 and 86, respectively. The increased expression
levels of lnc‐HOTAIR more than 68 in HCC patients following DAAs were correlated
with poorer disease outcomes compared to those with lower expression levels;
however, ATG‐7 expression levels more than 114 were correlated with worse
overall survival but not the progression‐free one. We suggest that high expression
levels of lnc‐HOTAIR could serve as a risk assessment biomarker for HCC before and
during DAAs course therapy in Chronic HCV‐4 patients, and should be rigorously
taken into consideration before DAAs.