BACKGROUND AND AIMS: The aim of the study was to evaluate the risk of hepatocellular carcinoma (HCC) development after treatment with direct-acting antivirals (DAAs) and to compare HCC occurrence in these patients with that among patients treated with interferon (IFN)-based therapies. METHODS: We analyzed a large cohort with chronic hepatitis C virus patients for the onset of new HCC after DAA treatment. A historical IFN-treated cohort was investigated for comparison. RESULTS: A total of 819 patients were included in the DAA group. The median follow-up period was 263 days (0-1,001). Twenty-five patients (3.6 HCCs/100 person-years; 3.1%) were diagnosed with de novo HCC within the time of observation. No patient without cirrhosis had developed HCC. Patients with newly diagnosed HCC were mostly male, older, and treatment-experienced and had a lower 12-week sustained virologic response (SVR12) rate and higher levels of liver inflammation markers. The median time to HCC was 312 days (0-880). Investigation of the subcohort of 269 cirrhotic patients yielded an HCC rate of 8.9 HCCs/100 person-years. In this cohort, non-SVR12 was an independent risk factor for de novo HCC (HR 4.48; 95% CI 1.51-13.12; p = 0.007). Twenty-four patients (96%) with new HCC were Child-Pugh class A and 17 (68%) were diagnosed in early BCLC stage A. For the IFN-treated patients, we calculated an overall risk of HCC occurrence of 1.3/100 person-years (19 patients out of 351; 5.4%). The median time to diagnosis was 38.8 months (0-113). CONCLUSION: The de novo HCC rates did not differ between the DAA-treated patients and those who received IFN. Achievement of SVR is of utmost importance for HCC prevention.
BACKGROUND AND AIMS: The aim of the study was to evaluate the risk of hepatocellular carcinoma (HCC) development after treatment with direct-acting antivirals (DAAs) and to compare HCC occurrence in these patients with that among patients treated with interferon (IFN)-based therapies. METHODS: We analyzed a large cohort with chronic hepatitis C virus patients for the onset of new HCC after DAA treatment. A historical IFN-treated cohort was investigated for comparison. RESULTS: A total of 819 patients were included in the DAA group. The median follow-up period was 263 days (0-1,001). Twenty-five patients (3.6 HCCs/100 person-years; 3.1%) were diagnosed with de novo HCC within the time of observation. No patient without cirrhosis had developed HCC. Patients with newly diagnosed HCC were mostly male, older, and treatment-experienced and had a lower 12-week sustained virologic response (SVR12) rate and higher levels of liver inflammation markers. The median time to HCC was 312 days (0-880). Investigation of the subcohort of 269 cirrhotic patients yielded an HCC rate of 8.9 HCCs/100 person-years. In this cohort, non-SVR12 was an independent risk factor for de novo HCC (HR 4.48; 95% CI 1.51-13.12; p = 0.007). Twenty-four patients (96%) with new HCC were Child-Pugh class A and 17 (68%) were diagnosed in early BCLC stage A. For the IFN-treated patients, we calculated an overall risk of HCC occurrence of 1.3/100 person-years (19 patients out of 351; 5.4%). The median time to diagnosis was 38.8 months (0-113). CONCLUSION: The de novo HCC rates did not differ between the DAA-treated patients and those who received IFN. Achievement of SVR is of utmost importance for HCC prevention.
Authors: M Guarino; F Morisco; M R Valvano; A M Ippolito; M Librandi; N Andriulli; M Greco; A Amoruso; A Iacobellis; G Niro; N Caporaso; A Andriulli Journal: Aliment Pharmacol Ther Date: 2017-03-06 Impact factor: 8.171
Authors: Hamish Innes; Stephen T Barclay; Peter C Hayes; Andrew Fraser; John F Dillon; Adrian Stanley; Andy Bathgate; Scott A McDonald; David Goldberg; Heather Valerio; Ray Fox; Nick Kennedy; Pete Bramley; Sharon J Hutchinson Journal: J Hepatol Date: 2017-11-16 Impact factor: 25.083
Authors: Adriaan J van der Meer; Bart J Veldt; Jordan J Feld; Heiner Wedemeyer; Jean-François Dufour; Frank Lammert; Andres Duarte-Rojo; E Jenny Heathcote; Michael P Manns; Lorenz Kuske; Stefan Zeuzem; W Peter Hofmann; Robert J de Knegt; Bettina E Hansen; Harry L A Janssen Journal: JAMA Date: 2012-12-26 Impact factor: 56.272
Authors: Marc Bourlière; Stuart C Gordon; Steven L Flamm; Curtis L Cooper; Alnoor Ramji; Myron Tong; Natarajan Ravendhran; John M Vierling; Tram T Tran; Stephen Pianko; Meena B Bansal; Victor de Lédinghen; Robert H Hyland; Luisa M Stamm; Hadas Dvory-Sobol; Evguenia Svarovskaia; Jie Zhang; K C Huang; G Mani Subramanian; Diana M Brainard; John G McHutchison; Elizabeth C Verna; Peter Buggisch; Charles S Landis; Ziad H Younes; Michael P Curry; Simone I Strasser; Eugene R Schiff; K Rajender Reddy; Michael P Manns; Kris V Kowdley; Stefan Zeuzem Journal: N Engl J Med Date: 2017-06-01 Impact factor: 91.245
Authors: Fatih Karbeyaz; Seraphina Kissling; Paul Julius Jaklin; Jaqueline Bachofner; Barbara Brunner; Beat Müllhaupt; Thomas Winder; Joachim C Mertens; Benjamin Misselwitz; Stefanie von Felten; Alexander R Siebenhüner Journal: J Hepatocell Carcinoma Date: 2021-06-11