Hepatocellular carcinoma and hepatitis C virus treatments: The bold and the beautiful

Abstract

The occurrence of hepatocellular carcinoma (HCC) is one of the most serious complications of hepatitis C virus (HCV) infection. Recently, effective antiviral medications have made sustained viral response (SVR) or cure a realistic therapeutic goal for most chronic HCV patients. Given HCV's tumorigenic propensity, it is not surprising that achieving SVR is helpful in preventing HCC. This review briefly summarizes and discusses the existing evidence on the relationship between hepatic carcinogenesis and viral eradication by antivirals, which is mainly divided into interferon‐based and direct‐acting antivirals (DAAs) based therapy. DAAs have changed the treatment landscape of chronic HCV, reaching high rates of SVR even in patients with advanced cirrhosis, with few contraindications and little side effects. Although some early reports suggested that DAA treatment increased the chance of HCC occurrence, more subsequent observational studies have refuted this theory. The probability of HCC recurrence after HCV eradication appears to be decreasing over time following SVR. Despite virological suppression/cure, individuals with liver cirrhosis are still at risk of HCC and should be monitored. There is a considerable need for markers/scores to predict the long‐term risk of HCC in patients with HCV‐related liver disease who attain SVR with direct‐acting antivirals.

Etiological changes of liver cirrhosis and hepatocellular carcinoma‐complicated liver cirrhosis in Japan: Updated nationwide survey from 2018 to 2021

“…Viral hepatitis‐associated LC, particularly HCV‐associated LC, is recognized to have an extremely high risk of HCC, 27,28 and HCV infection was the most frequent cause of LC with HCC in a previous survey 14 . However, several recent surveys have suggested that HCC of nonviral etiologies is becoming increasingly important in Japan 29–34 .…”

Pattern and burden of thrombocytopenia in chronic hepatitis C virus patients at a tertiary care hospital

“…Hepatitis C denotes inflammation of the liver caused by the Hepatitis C Virus (HCV) [3]. HCV infection is a global health concern, affecting over 170 million individuals, which accounts for roughly 3% of the world's population [9,10]. As of an estimate conducted in January 2021, 9,746,000 Pakistanis are HCV positive which corresponds to a prevalence of 4.3% [11].…”

Recent Insights into the Biomarkers, Molecular Targets and Mechanisms of Non-Alcoholic Steatohepatitis-Driven Hepatocarcinogenesis

“…The global epidemic of obesity and metabolic syndrome has become a significant threat to human health worldwide. Recent epidemiological evidence shows that non-alcoholic fatty liver disease (NAFLD), recently termed metabolic dysfunction-associated steatotic liver disease (MASLD), and steatohepatitis (NASH) have rapidly become leading etiologies predisposing to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) development due to the rapid increase in metabolic syndrome and obesity in the past decades and newly available therapies for hepatitis C (HCV) and B virus (HBV)-associated HCC [ 1 , 2 , 3 , 4 ] ( Figure 1 ). NAFLD/NASH-HCC is known to have even lower survival rates than viral hepatitis HCC and is generally developed based on metabolic syndrome, hyperinsulinemia, insulin resistance, and dyslipidemia, and is characterized by fat accumulation in the liver, either due to the increased inflow of free fatty acids or de novo lipogenesis [ 3 , 4 ].…”