HCC Incidence in DAAs-Treated and Untreated Egyptian HCV-Infected Patients

Abstract

Background and study aim: It was initially presumed that SVR after DAAs would be associated with a reduction in incidence of new or recurrent HCC. However, suggesting that DAAs may increase the risk of HCC recurrence created uncertainty in the field. This was followed by publication of number of studies in various populations looking at both new and recurrent HCC.The aim of this article is t study the incidence rate of HCC in DAAs-treated patients who have achieved SVR12 and those who haven’t been treated. Patients and Methods: 416 patients were randomly-selected for prospective follow-up screening for the incidence of HCC (by abdominal U/S and AFP) at a 6-months interval for a completed 12 months duration on 1st, 2nd and 3rd screening sessions. They were distributed 132, 112 and 162 patients in groups I (SOF-treated), II (Qurevo-treated) and III (DAAs-ineligible cirrhotic patients). The DAAs-treated patients were selected from those who had achieved SVR12. Patients who didn’t attend the 3 screening sessions were excluded from the prospective analysis. Results: 297 patients completed the 3 screening sessions, distributed 100, 97 and 100 in groups I, II and III respectively. The total incidence of HCC at the 3 screening sessions was significantly-higher among Group III 30% (30/100 patients) versus 19% (19/100 patients) in Group I and 1.03% (1/97 patients) in Group II. Conclusion: The HCC incidence was significantly lower in DAAs-treated patients who achieved SVR12. The incidence of HCC was significantly higher in patients with advanced stages of cirrhosis.