The treatment of hepatitis C virus (HCV) infection is possible in patients who have been successfully treated for hepatocellular carcinoma (HCC), and the best results were achieved with the use of multiple direct-acting antivirals (DAAs) and ribavirin (RBV), according to new findings published in the European Journal of Gastroenterology & Hepatology. However, HCC recurrence was noted to be high and was observed in 42% of patients. In this study group, 80.7% had recurrence within 6 months of treatment initiation.
Treatment of HCV in patients with advanced liver disease became a reality with the advent of DAA regimens. The current study describes the results of HCV treatment with DAAs in 62 patients with HCC who achieved a complete radiologic response after treatment of cancer.
Patients received one of 4 HCV treatment regimens: group 1 was given sofosbuvir (SOF)+RBV for 24 weeks, group 2 was given SOF+simeprevir for 12 weeks, group 3 received SOF+daclatasvir (DAC) for 24 weeks, and group 4 received SOF+DAC+RBV for 12 weeks.
The median follow-up was 12 months after treatment was initiated.
An overall response rate of 64.5% was achieved, with the highest rate seen with the SOF/DAC/RBV regimen for 12 weeks, at 87.5%, and the lowest was 26.7%, with 24 weeks of SOF/RBV.
The highest HCC recurrence rates were observed in patients treated with transarterial chemoembolization (66.7%) and the lowest was in patients treated with surgical resection or combined measures (0% for both, P =.04).
“Recurrence of HCC after DAA treatment is not an uncommon ﬁnding and more controlled trials are needed to clarify or deny the possible relationship,” write the authors.
Hassany M, Elsharkawy A, Maged A, et al. Hepatitis C virus treatment by direct-acting antivirals in successfully treated hepatocellular carcinoma and possible mutual impact [published online May 31, 2018]. Eur J Gastroenterol Hepatol. doi: 10.1097/MEG.0000000000001152