Abstract

With the introduction of direct-acting antiviral (DAA) agents, hepatitis C virus (HCV) treatment has dramatically improved. However, there are insufficient data on the benefits of DAA therapy in hepatocellular carcinoma (HCC). The purpose of this study was to investigate the outcome of patients who received DAA therapy after HCC treatment. We retrospectively reviewed patients with HCV-related HCC in a single medical center, and the outcome of patients with or without DAA therapy was analyzed. In total, 107 HCC patients were enrolled, of whom 60 had received DAA therapy after treatment for HCC. There were no significant intergroup differences in age, sex, laboratory results, or tumor burden. A more advanced stage was noted in the no DAA group (P = 0.003). In the treatment modality, sorafenib was commonly prescribed in the no DAA group (P = 0.007). The DAA group had a longer overall survival (OS) time than the no DAA group (P<0.001). When stratified by Barcelona Clinic Liver Cancer staging, the DAA group had better OS in the HCC stages 0-A and B-C (P = 0.034 and P = 0.006). There were 35 patients who received DAA therapy after curative HCC therapy. At a median follow-up of 20 months, 37.1% patients had HCC recurrence after DAA therapy. There was no statistical difference in recurrence-free survival between patients receiving and those not receiving DAA (P = 0.278). DAA therapy improved the survival outcome of HCC patients and did not increase recurrent HCC after curative therapy. .

Highlights

  • Chronic hepatitis C virus (HCV) infection is an inflammatory process of the liver that progressively leads to cirrhosis in about 20–30% of patients [1]

  • Among 107 hepatitis C-related hepatocellular carcinoma (HCC) patients, 60 patients were treated with direct-acting antiviral (DAA) after HCC management (DAA group) and 47 patients did not receive any HCV therapy

  • More advanced HCC was noted in the no DAA group (P = 0.003)

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Summary

Introduction

Chronic hepatitis C virus (HCV) infection is an inflammatory process of the liver that progressively leads to cirrhosis in about 20–30% of patients [1]. The annual risk of hepatocellular carcinoma (HCC) is around 3% in HCV patients with cirrhosis [1]. Of all HCV-related HCC, 80– 90% occur in the setting of cirrhosis [1]. Eradication of HCV has been associated with a decreased risk of developing HCC at any stage of fibrosis [2]. The first anti-HCV drugs, predominantly PEGylated interferon-α and ribavirin, can achieve sustained virologic response (SVR) rates in approximately 55% of patients [3].

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