Abstract
BackgroundThe impact of direct-acting antivirals (DAAs) remains a debate, whether they accelerate the recurrence rate of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after curative therapy. We evaluated the impact of direct-acting antiviral therapy on the rate of recurrence of HCV-related hepatocellular carcinoma following intervention in Egyptian patients.ResultsThe results of the study represented an HCC recurrence rate of 38% in patients who received direct-acting antiviral therapy after HCC intervention versus 62% in those who did not receive antiviral therapy. In group I, according to the Barcelona Clinic of Liver Cancer (BCLC) staging, a higher recurrence rate was observed (57.9%) among patients who were classified as BCLC stage B.ConclusionsHCC patients who did not receive direct-acting antiviral therapy after HCC intervention had a greater risk of HCC recurrence. DAAs did not increase the risk of HCC recurrence following HCC treatment; however, it did not abolish it. Close monitoring of patients after antiviral therapy is recommended.
Highlights
The impact of direct-acting antivirals (DAAs) remains a debate, whether they accelerate the recurrence rate of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after curative therapy
Comparing different HCC treatment modalities between groups I and II In group I, 11 patients underwent hepatic resection, 27 patients underwent radiofrequency ablation (RFA), 10 patients treated with LDLT, and two patients treated with alcohol injection, while in group II, 12 patients underwent hepatic resection, 35 patients underwent RFA, and 3 patients treated with alcohol injection (Table 2)
The impact of DAA-based treatment on the incidence of hepatocellular carcinoma (HCC) in patients with cirrhosis and on the incidence of HCC recurrence after successful curative treatment has emerged as a controversial issue with potential clinical implications [19]
Summary
The impact of direct-acting antivirals (DAAs) remains a debate, whether they accelerate the recurrence rate of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after curative therapy. We evaluated the impact of direct-acting antiviral therapy on the rate of recurrence of HCV-related hepatocellular carcinoma following intervention in Egyptian patients. Liver cirrhosis is the most crucial risk factor for hepatocellular carcinoma (HCC) [1]. Achieving SVR is the single most important factor predicting a lower risk of developing HCV-induced HCC, providing a 20% reduction rate in the incidence of HCC [7]. The introduction of highly effective direct-acting antivirals (DAAs) was conventionally expected by practicing hepatologists to lead to the extension of this benefit to all patients, including those who were not candidates for IFN-based therapy [8]. The clinical experience of using DAAs has resulted in a major debate with important clinical implications regarding the
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