Reduced Risk for Hepatocellular Carcinoma in DAA-Treated HCV Infection
Failure to achieve sustained virologic response was strongly associated with development of hepatocellular carcinoma.
Patients with advanced hepatitis C infection being treated with direct-acting antivirals (DAAs) may have a reduced risk for being diagnosed with hepatocellular carcinoma (HCC) during the first year and further declines after 1 year, according to results published in the Journal of Hepatology.
The study used data from the NAVIGATORE platform, a prospectively recording database of all patients with hepatitis C infection receiving DAAs in the Veneto region of Italy. Participants who were included had liver fibrosis stage ≥F3.
Of 3917 participants with a mean follow-up of 536.2±197.6 days, 55 were diagnosed with HCC. During the first year, HCC incidence was 0.46% (95% CI, 0.12-1.17) in patients with fibrosis stage F3, 1.49% (95% CI, 1.03-2.08) in participants with Child-Pugh-A, and 3.61% (95% CI, 1.86-6.31) in participants with Child-Pugh-B. In the second year, HCC incidences were 0%, 0.2%, and 0.69%, respectively.
After analysis, the researchers found that hepatocellular carcinoma was significantly associated with an AST to Platelet Ratio Index ≥2.5 (HR, 2.03; 95% CI, 1.14- 3.61; P =.016) and hepatitis B (HR, 3.99; CI, 1.24-12.91; P =.021).
They also found that failure to achieve sustained virologic response was strongly associated with the development of HCC (HR, 9.09; CI, 5.2-16.1; P =.0001).
Of the participants who were diagnosed with hepatocellular carcinoma, 29% had an aggressive tumor, often seen in the early phase of treatment.
Romana A, Angeli P, Piovesan S, et al. Newly diagnosed hepatocellular carcinoma in patients with advanced hepatitis C treated with DAAs: a prospective population study [published online March 15, 2018]. J Hepatol. doi:10.1016/j.jhep.2018.03.009