Clinical outcomes of direct‐acting antiviral treatments for patients with hepatitis C after hepatocellular carcinoma are equivalent to interferon treatment

Tahata, Yuki; Sakamori, Ryotaro; Urabe, Atsushi; Yamada, Ryotaro; Ohkawa, Kazuyoshi; Hiramatsu, Naoki; Hagiwara, Hideki; Oshita, Masahide; Imai, Yumiko; Kodama, Tatsuhiko; Tatsumi, Tomohide; Takehara, Tetsuo

doi:10.1111/hepr.13547

Cited by 18 publications

(15 citation statements)

References 35 publications

(75 reference statements)

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“…On the other hand, whether or not it contributes to the improvement of recurrence-free survival is debatable. Initially, the possibility of early recurrence after DAA treatment was suggested [ 36 , 37 ]; however, subsequent reports, including meta-analyses, have shown no difference in the risk of recurrence when compared to IFN treatment [ 38 – 41 ]. Although time bias cannot be excluded completely, a recent report showed that the recurrence rate was significantly lower in the group that achieved SVR by DAA treatment after HCC treatment compared with the untreated group [ 32 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy

et al. 2022

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Background and aim The long-term prognosis of hepatocellular carcinoma (HCC) treated at a very-early-stage (the Barcelona Clinical Liver Cancer (BCLC) classification stage 0) was unclear, especially in terms of background liver disease. Methods This single-center, retrospective study included 302 patients with BCLC stage 0 HCC treated with radiofrequency ablation (RFA) and followed for at least six months. We examined the impact of background liver disease on overall survival and recurrence. Results The median age was 72 (range; 36–91) years; the median tumor diameter was 15 (range; 8–20) mm. The etiologies of background liver disease were hepatitis B virus infection (HBV) in 24 cases, hepatitis C virus infection (HCV) in 195 cases, and non-viral (NBNC) in 83 cases. Among the patients with HCV, 63 had achieved sustained virological response (SVR) by antiviral therapy (HCV SVR) before developing HCC (n = 37) or after HCC treatment (n = 26), and 132 had active HCV infection (HCV non-SVR). The median overall survival was 85 (95% CI; 72–98) months, and the median recurrence-free survival was 26 (95% CI; 20–30) months. Active infection with hepatitis C virus negatively contributed to overall survival (HR 2.91, 95% CI 1.31–3.60, p = 0.003) and recurrence-free survival (HR 1.47, 95% CI 1.06–2.05, p = 0.011). Conclusions The prognosis of RFA treatment for very early-stage HCC was favorable. Achieving SVR in hepatitis C was important for further prognosis improvement.

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Section: Discussionmentioning

confidence: 99%

The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy

et al. 2022

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“…Diabetes mellitus was defined according to the guidelines of the American Diabetes Association, 13 as in our previous report. 14 Patients with cirrhosis were defined as those who met one of the following criteria. Among the patients who underwent liver biopsy, patients with a METAVIR score of F4 were defined as having This study was performed in line with the ethics guidelines outlined in the Declaration of Helsinki and was approved by the institutional review boards of all participating hospitals (University Hospital Medical Information Network: 000015247, 000018561, 000020019, 000017703, 000025050, 000037575).…”

Section: Patientsmentioning

confidence: 99%

Prediction model for hepatocellular carcinoma occurrence in patients with hepatitis C in the era of direct‐acting anti‐virals

Tahata¹,

Sakamori²,

Yamada³

et al. 2021

Aliment Pharmacol Ther

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Background: Several factors associated with hepatocellular carcinoma (HCC) occurrence after sustained virological response (SVR) in patients with hepatitis C have been reported. However, few validation studies have been performed in the era of direct-acting anti-virals (DAAs). Aims:To develop a prediction model for HCC occurrence after DAA-mediated SVR and validate its usefulness. Methods:We analysed 2209 patients with SVR and without a history of HCC who initiated DAA treatment at 24 Japanese hospitals. These patients were divided into a training set (1473 patients) and a validation set (736 patients). Results:In the training set, multivariate Cox proportional hazards analysis showed that the baseline BMI (≥25.0 kg/m 2 , P = 0.024), baseline fibrosis-4 (FIB-4) index (≥3.25, P = 0.001), albumin level at SVR (<4.0 g/dL, P = 0.010) and alpha-foetoprotein level at SVR (≥5.0 ng/mL, P = 0.006) were significantly associated with HCC occurrence. We constructed a prediction model for HCC occurrence with these four factors (2 points were added for the FIB-4 index, and 1 point was added for each of the other three factors). Receiver operating characteristics curve analysis identified a score of 2 as the optimal cut-off value for the prediction model (divided into 0-1 and 2-5). In the validation set, the sensitivity and negative predictive value for HCC occurrence were 87.5% and 99.7%, respectively, at 2 years and 71.4% and 98.0%, respectively, at 3 years. Conclusion:A prediction model combining these four factors contributes to an efficient surveillance strategy for HCC occurrence after DAA-mediated SVR.

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“…In a more recent international multicenter retrospective study published in 2020, there was no increase in the risk of HCC recurrence or the risk of mortality in patients with HCC waiting for liver transplantation[ 69 ]. Another group reported no difference in the behavior of HCC recurrence or mortality rates in patients who achieved SVR after either IFN or DAAs[ 70 ].…”

Section: Association Between Hcc Recurrence and Daasmentioning

confidence: 99%

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

Kamal¹,

Elsheaita²,

Abdelnabi³

2022

WJCC

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Since direct-acting antiviral agents (DAAs) have been introduced into hepatitis C virus treatment, the sustained viral response (SVR) rate has significantly increased to more than 95%. Scientific evidence supports the idea that SVR after interferon therapy has beneficial effects related to cirrhosis progression, resulting in a reduction in the incidence of hepatocellular carcinoma (HCC). However, a significant debate exists related to DAA impact on HCC development. We reviewed the current literature highlighting the controversial data related to DAA association with de novo HCC occurrence or recurrence and possible pathophysiology of HCC related to DAAs. After a review of the published literature, we believe that the current evidence does not confirm or repudiate a higher rate of de novo HCC occurrence or recurrence related to DAA therapy. More trials are needed to determine if there is an association between HCC occurrence or recurrence and DAA or if it is related to preexisting liver cirrhosis.

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Clinical outcomes of direct‐acting antiviral treatments for patients with hepatitis C after hepatocellular carcinoma are equivalent to interferon treatment

Cited by 18 publications

References 35 publications

The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy

The impact of background liver disease on the long-term prognosis of very-early-stage HCC after ablation therapy

Prediction model for hepatocellular carcinoma occurrence in patients with hepatitis C in the era of direct‐acting anti‐virals

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

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