Association between direct-acting antiviral agents in hepatitis C virus treatment and hepatocellular carcinoma occurrence and recurrence: The endless debate

Kamal, Ahmed; Elsheaita, Ahmed; Abdelnabi, Mahmoud

doi:10.12998/wjcc.v10.i6.1764

Cited by 7 publications

(5 citation statements)

References 73 publications

(93 reference statements)

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“…Because of the existence of contradictory data, the link between DAA therapy and HCC has been called into question, prompting further debate. [17] .…”

Section: Discussionmentioning

confidence: 99%

Direct Acting Anti-Viral Therapy, and Potential Increase in the Incidence of Hepato-Cellular Carcinoma in Cirrhotic Patients With Hepatitis C Virus

Fekry¹,

Elmaqsoud²,

Elewa³

et al. 2023

Journal of Medical and Life Science

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Background: Direct-acting anti-viral drugs (DAAs) have become widely used for cirrhotic patients with hepatitis C infection. Virological responses are excellent with SVR rate in > 90% of cirrhotic patients. The association between the use of DAAs and the development of hepatocellular carcinoma (HCC) is debatable. Aim of the work: investigate the incidence of HCC and characteristics of tumors after DAAs therapy. Patients and methods:A prospective study of a cirrhotic patient with chronic hepatitis c virus who received 12 weeks of DAAs therapy (sofosbuvir, daclatasivir) in Mansoura specialized medical hospital and followed up for 6 months post-treatment. Untreated cirrhotic patients with hepatitis C infection for comparison.Results: amongst (27/30) 90% of patients achieved sustained virological response 12 weeks post-treatment there were 3/30 (10%) not responded, and 7/30 from treated patients vs 11/30 untreated patients had de novo HCC. Conclusion:DAAs reduced the incidence of HCC but with no significant difference with the untreated patient (refuse treatment) after six months, however, the pattern of tumor characteristics is very aggressive in the treated patient.

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“…Because of the existence of contradictory data, the link between DAA therapy and HCC has been called into question, prompting further debate. [17] .…”

Section: Discussionmentioning

confidence: 99%

Direct Acting Anti-Viral Therapy, and Potential Increase in the Incidence of Hepato-Cellular Carcinoma in Cirrhotic Patients With Hepatitis C Virus

Fekry¹,

Elmaqsoud²,

Elewa³

et al. 2023

Journal of Medical and Life Science

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“…[9]. Even though DAAs are associated with higher SVR, there is still debate concerning the relationship between DAAs and the development, recurrence, morphological, and clinical characteristics of de novo HCC [10,11]. Our goal was to study the factors of HCC associated with direct antiviral treatments for hepatitis C infection.…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular Carcinoma Post Direct Anti Hepatitis C Viral Agents; Clinical Features

Ahmed

Elwan

Abdelrahman

et al. 2022

African Journal of Gastroenterology and Hepatology

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Background:Direct Anti Hepatitis C Viral Agents (DAAs) were introduced for Hepatitis C Virus (HCV) infection management, which resulted in high sustained virological response (SVR) in many countries and a low failure rate. However, hepatocellular carcinoma (HCC) post DAAs therapy is controversial; few studies related aggressive pattern HCC to DAAs. Therefore, we aimed to study the hepatocellular carcinoma relation to direct anti-hepatitis C viral drugs. Patients and Methods: This observational case-control study included 67 adult Egyptian HCC patients associated with HCV diagnosed at the Zagazig University Hospitals, who were divided into two groups according to DAAs treatment. Results:HCC is more common in male patients (77.6%) of all studied cases, and those are treated by DAAs (62.7%). The median age of HCC post DAA was 63(48-83), while 58 (45-75) in HCC patients without DAA, with no significant difference p= 0.053. HCC presented in the non-DAAs treated group, mainly decompensating by hematemesis (HM) (32%). While in the post-DAAs group, HCC was significantly diagnosed mainly by abdominal pain at 31%. There is no significant difference as regards the liver status with frequent liver cirrhosis in both groups, 14(56%) and 32(76.2%). Liver cirrhosis (p-value 0.04) and advanced Child-Pugh classification (p-value 0.009) are predictors of DAAs-related HCC. Conclusion: DAAs therapy of HCV added no additional risk for hepatocellular carcinoma.

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“…The second opinion is that the matter has not been settled, and all available studies produce conflicting results [55,56,155,200,201] .…”

Section: Daas and Hcc Developmentmentioning

confidence: 99%

Hepatocellular carcinoma after treatment of hepatitis C with direct-acting antivirals: a critical re-appraisal

Tsomidis¹,

Voumvouraki²

2023

Hepatoma Res

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Soon after introducing direct-acting antiviral agents (DAAs) for chronic hepatitis C treatment, there began a debate over the possibility of hepatocellular carcinoma (HCC) after viral clearance. Although several reports suggested that the question has been answered negatively, other reports suggested the opposite. The present review presents data in favor and against the null hypothesis and analyzes the scientific background of the possible participation of DAAs in HCC development. The reasons for the discrepancy among studies are presented. These include heterogeneity of patient selection, the nature of the studies, and the tumors themselves are responsible for varying results. Exogenous factors like alcohol consumption or metabolic syndrome confound these findings and suggest the need for statistical adjustments. The need for careful attention to the statistical details is exemplified, and the significant points of almost universal agreements are identified. The conclusion is that the definitive study is impossible for ethical and scientific reasons, and the physician should not ignore even simple personal observations and screening of all patients with extensive fibrosis in HCC, irrespective of sustained virologic response, until a robust, reliable prognostic model can be invented.

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Association between direct-acting antiviral agents in hepatitis C virus treatment and hepatocellular carcinoma occurrence and recurrence: The endless debate

Cited by 7 publications

References 73 publications

Direct Acting Anti-Viral Therapy, and Potential Increase in the Incidence of Hepato-Cellular Carcinoma in Cirrhotic Patients With Hepatitis C Virus

Direct Acting Anti-Viral Therapy, and Potential Increase in the Incidence of Hepato-Cellular Carcinoma in Cirrhotic Patients With Hepatitis C Virus

Hepatocellular Carcinoma Post Direct Anti Hepatitis C Viral Agents; Clinical Features

Hepatocellular carcinoma after treatment of hepatitis C with direct-acting antivirals: a critical re-appraisal

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