F Mettke1, B Schlevogt2, K Deterding1, A Wranke1, A Smith3, K Port1, M P Manns1,4,5, A Vogel1, M Cornberg1,4, H Wedemeyer1,4,5. 1. Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. 2. Department of Transplantation Medicine, University of Muenster, Muenster, Germany. 3. Institute of Biostatistics, Hannover Medical School, Hannover, Germany. 4. Integrated Research and Treatment Center - Transplantation (IFB-Tx), Hannover Medical Hannover, Hannover, Germany. 5. Partner Site Hannover-Braunschweig, German Center for Infection Research (DZIF), Germany.
Abstract
BACKGROUND: Hepatitis C virus (HCV) clearance with IFN-based therapies reduces the incidence of hepatocellular carcinoma (HCC). There has been some debate if IFN-free therapy with direct-acting antivirals alters the risk for HCC. AIM: To investigate the HCC incidence in cirrhotic HCV patients who cleared HCV with direct-acting antivirals vs untreated controls. METHODS: We prospectively monitored 373 patients with chronic hepatitis C who received IFN-free therapies with direct-acting antiviral after January 2014. A retrospective control cohort of untreated cirrhotic patients was recruited out of 3715 HCV patients who were followed at our centre between 2007 and 2013, with similar HCC screening protocols. RESULTS: 158 direct-acting antiviral-treated and 184 control patients with liver cirrhosis were included in this analysis. The groups did not differ in gender and genotype distribution, severity of liver disease and prevalence of diabetes mellitus. Patients were followed up for a median of 440 (range 91-908) and 592 (range 90-1000) days. HCCs developed in 6 and 14 patients during follow-up, resulting in an incidence of 2.90 vs 4.48 HCCs per 100 person-years. In the direct-acting antiviral-treated group, there was no new case of HCC later than 450 days after treatment initiation. In multivariate analysis, higher MELD-Scores and AFP-levels were independently associated with HCC development. Transplant-free patient survival was similar in both groups. CONCLUSIONS: IFN-free direct-acting antiviral therapy of chronic hepatitis C does not alter the short-term risk for HCC in patients with liver cirrhosis. A reduced HCC incidence may become evident after more than 1.5 years of follow-up.
BACKGROUND:Hepatitis C virus (HCV) clearance with IFN-based therapies reduces the incidence of hepatocellular carcinoma (HCC). There has been some debate if IFN-free therapy with direct-acting antivirals alters the risk for HCC. AIM: To investigate the HCC incidence in cirrhotic HCVpatients who cleared HCV with direct-acting antivirals vs untreated controls. METHODS: We prospectively monitored 373 patients with chronic hepatitis C who received IFN-free therapies with direct-acting antiviral after January 2014. A retrospective control cohort of untreated cirrhotic patients was recruited out of 3715 HCVpatients who were followed at our centre between 2007 and 2013, with similar HCC screening protocols. RESULTS: 158 direct-acting antiviral-treated and 184 control patients with liver cirrhosis were included in this analysis. The groups did not differ in gender and genotype distribution, severity of liver disease and prevalence of diabetes mellitus. Patients were followed up for a median of 440 (range 91-908) and 592 (range 90-1000) days. HCCs developed in 6 and 14 patients during follow-up, resulting in an incidence of 2.90 vs 4.48 HCCs per 100 person-years. In the direct-acting antiviral-treated group, there was no new case of HCC later than 450 days after treatment initiation. In multivariate analysis, higher MELD-Scores and AFP-levels were independently associated with HCC development. Transplant-free patient survival was similar in both groups. CONCLUSIONS: IFN-free direct-acting antiviral therapy of chronic hepatitis C does not alter the short-term risk for HCC in patients with liver cirrhosis. A reduced HCC incidence may become evident after more than 1.5 years of follow-up.
Authors: Michael L Cheng; Mohamed S Abdel-Hakeem; Sophie E Cousineau; Jason Grebely; Alison D Marshall; Sahar Saeed; Selena M Sagan; Naglaa H Shoukry; Jordan J Feld; Sonya A MacParland Journal: Can Liver J Date: 2018-10-03
Authors: Ekram W Abd El-Wahab; Waleed M Abd Elgawad; Mohamed S Abdelaziz; Ashraf I Mikheal; Hanan Z Shatat Journal: Am J Trop Med Hyg Date: 2022-02-28 Impact factor: 3.707
Authors: J Chhatwal; Q Chen; T Ayer; E D Bethea; F Kanwal; K V Kowdley; X Wang; M S Roberts; S C Gordon Journal: Aliment Pharmacol Ther Date: 2018-01-29 Impact factor: 8.171
Authors: Solomon Owusu Sekyere; Bernhard Schlevogt; Friederike Mettke; Mohammad Kabbani; Katja Deterding; Thomas Christian Wirth; Arndt Vogel; Michael Peter Manns; Christine Susanne Falk; Markus Cornberg; Heiner Wedemeyer Journal: Liver Cancer Date: 2018-07-18 Impact factor: 11.740
Authors: Ponni V Perumalswami; Brooke Wyatt; Chip A Bowman; Krupa Patel; Anna Mageras; Sara C Lewis; Andrea D Branch Journal: Cancer Med Date: 2022-03-09 Impact factor: 4.711