Reduced Risk for Hepatocellular Carcinoma in DAA-Treated HCV Infection

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Failure to achieve sustained virologic response was strongly associated with development of hepatocellular carcinoma.
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.

Reference

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

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