BACKGROUND AND AIMS: Arrival of direct-acting antiviral agents against hepatitis C virus with high-sustained virological response rates and very few side effects has drastically changed the management of hepatitis C virus infection. The impact of direct-acting antiviral exposure on hepatocellular carcinoma recurrence after a first remission in patients with advanced fibrosis remains to be clarified. METHODS: 68 consecutive hepatitis C virus patients with a first hepatocellular carcinoma diagnosis and under remission, subsequently treated or not with a direct-acting antiviral combination, were included. Clinical, biological and virological data were collected at first hepatocellular carcinoma diagnosis, at remission and during the surveillance period. RESULTS: All patients were cirrhotic. Median age was 62 years and 76% of patients were male. Twenty-three patients (34%) were treated with direct-acting antivirals and 96% of them achieved sustained virological response. Median time between hepatocellular carcinoma remission and direct-acting antivirals initiation was 7.2 months (IQR: 3.6-13.5; range: 0.3-71.4) and median time between direct-acting antivirals start and hepatocellular carcinoma recurrence was 13.0 months (IQR: 9.2-19.6; range: 3.0-24.7). Recurrence rate was 1.7/100 person-months among treated patients vs 4.2/100 person-months among untreated patients (P=.008). In multivariate survival analysis, the hazard ratio for hepatocellular carcinoma recurrence after direct-acting antivirals exposure was 0.24 (95% confidence interval: 0.10-0.55; P<.001). CONCLUSIONS: Hepatocellular carcinoma recurrence rate was significantly lower among patients treated with direct-acting antivirals compared with untreated patients. Given the potential impact of our observation, large-scale prospective cohort studies are needed to confirm these results.
BACKGROUND AND AIMS: Arrival of direct-acting antiviral agents against hepatitis C virus with high-sustained virological response rates and very few side effects has drastically changed the management of hepatitis C virus infection. The impact of direct-acting antiviral exposure on hepatocellular carcinoma recurrence after a first remission in patients with advanced fibrosis remains to be clarified. METHODS: 68 consecutive hepatitis C viruspatients with a first hepatocellular carcinoma diagnosis and under remission, subsequently treated or not with a direct-acting antiviral combination, were included. Clinical, biological and virological data were collected at first hepatocellular carcinoma diagnosis, at remission and during the surveillance period. RESULTS: All patients were cirrhotic. Median age was 62 years and 76% of patients were male. Twenty-three patients (34%) were treated with direct-acting antivirals and 96% of them achieved sustained virological response. Median time between hepatocellular carcinoma remission and direct-acting antivirals initiation was 7.2 months (IQR: 3.6-13.5; range: 0.3-71.4) and median time between direct-acting antivirals start and hepatocellular carcinoma recurrence was 13.0 months (IQR: 9.2-19.6; range: 3.0-24.7). Recurrence rate was 1.7/100 person-months among treated patients vs 4.2/100 person-months among untreated patients (P=.008). In multivariate survival analysis, the hazard ratio for hepatocellular carcinoma recurrence after direct-acting antivirals exposure was 0.24 (95% confidence interval: 0.10-0.55; P<.001). CONCLUSIONS:Hepatocellular carcinoma recurrence rate was significantly lower among patients treated with direct-acting antivirals compared with untreated patients. Given the potential impact of our observation, large-scale prospective cohort studies are needed to confirm these results.
Authors: Carmen M Preda; Cristian Baicus; Irina Sandra; Alexandru Oproiu; Teodora Manuc; Ileana Constantinescu; Daniel Gavrila; Mircea Diculescu; Radu Dumitru; Catalin Vasilescu; Cristian Tieranu; Doina Istratescu; Theodor Voiosu; Mircea Manuc Journal: United European Gastroenterol J Date: 2019-03-29 Impact factor: 4.623
Authors: Michael K Turgeon; Shimul A Shah; Aaron M Delman; Benjamin V Tran; Vatche G Agopian; Joel P Wedd; Joseph F Magliocca; Ahyoung Kim; Andrew Cameron; Ali Olyaei; Susan L Orloff; Matthew P Anderson; Chandrashekhar A Kubal; Robert M Cannon; Jayme E Locke; Mary A Simpson; Mohamed E Akoad; Chelsey P Wongjirad; Juliet Emamaullee; Amika Moro; Federico Aucejo; Cyrus A Feizpour; Parsia A Vagefi; Mindie H Nguyen; Carlos O Esquivel; Kiran Dhanireddy; Vijay Subramanian; Alejandro Chavarriaga; Marwan M Kazimi; Maia S Anderson; Christopher J Sonnenday; Steven C Kim; David P Foley; Marwan Abdouljoud; Reena J Salgia; Dimitrios Moris; Debra L Sudan; Swaytha R Ganesh; Abhinav Humar; Majella Doyle; William C Chapman; Shishir K Maithel Journal: Ann Surg Date: 2021-10-01 Impact factor: 13.787
Authors: Ahmed Kamal; Amr Aly Abd Elmoety; Yousri Abdelmeguid Rostom; Mohamed Said Shater; Sameh Aldesoky Lashen Journal: Clin Exp Hepatol Date: 2021-03-11