Hepatocellular Carcinoma Recurrence in HCV Patients Treated with Direct Antiviral Agents

Sanduzzi‐Zamparelli, Marco; Boix, Loreto; Leal, Cassia Regina Guedes; Reig, María

doi:10.3390/v11050406

Cited by 16 publications

(16 citation statements)

References 68 publications

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“…The main limitations are the heterogeneity in the baseline characteristics of patients before initiating DAA treatment and during the follow-up and the radiological schedule of different patients across different cohorts and also within the same cohort [39]. Additionally, the reported information is sometimes only focused on patients who achieved SVR.…”

Section: Hcc Recurrence And/or Progression In Bclc-b/c Patients Treatmentioning

confidence: 99%

Antiviral therapy in the palliative setting of HCC (BCLC-B and -C)

Reig

Cabibbo

2021

Journal of Hepatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Hcc Recurrence And/or Progression In Bclc-b/c Patients Treatmentioning

confidence: 99%

Antiviral therapy in the palliative setting of HCC (BCLC-B and -C)

Reig

Cabibbo

2021

Journal of Hepatology

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“…Furthermore, as HCV is cleared from the body, it is possible that the body's immune response (surveillance) is lessened, allowing tumors to grow more easily. Finally, the presence of DAA-resistant HCV strains must be noted, as presence of active HCV strains may account for a higher HCC incidence rate [33]. Our case seeks to expand to the growing literature suggesting increased HCC recurrence rates in patients with HCV that have been treated with DAA agents compared with IFN treatment.…”

Section: Discussionmentioning

confidence: 93%

Timing disparity of hepatocellular carcinoma (HCC) recurrence in a patient receiving interferon and subsequent direct antiviral agent (DAA) therapy for chronic hepatitis C

Cao¹,

Halegoua-DeMarzio²,

Coben³

et al. 2020

Gastroenterol Hepatol Endosc

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The advent of direct acting antiviral (DAA) agents has redefined the treatment landscape for hepatitis C virus (HCV) within the past decade, with achievement of high HCV eradication rates.However, several reports have suggested an increased incidence of tumor recurrence following DAA treatment compared with interferon treatment. In adding to the evolving literature, we herein present a case of a 73-year-old female with long term follow up at our center, who had recurrence of previously treated HCC after 4 years and 7 months on maintenance interferon therapy and subsequent development of a new HCC after 14 months on DAA therapy. Tumor ablation consisted of successful trans-arterial chemoembolization and microwave ablation.

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“…Different studies have highlighted that the risk to develop HCC (de novo or recurrence) can persist (even if attenuated) after successful treatment with DAAs [ 1 , 5 , 32 ] particularly in cirrhotic patients. This can be due also to the persistence of pro-oncogenic stimuli even after the achievement of sustained virological response [ 1 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

Genetic Determinants in a Critical Domain of NS5A Correlate with Hepatocellular Carcinoma in Cirrhotic Patients Infected with HCV Genotype 1b

Alkhatib

Maio

Murtas

et al. 2021

Viruses

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HCV is an important cause of hepatocellular carcinoma (HCC). HCV NS5A domain-1 interacts with cellular proteins inducing pro-oncogenic pathways. Thus, we explore genetic variations in NS5A domain-1 and their association with HCC, by analyzing 188 NS5A sequences from HCV genotype-1b infected DAA-naïve cirrhotic patients: 34 with HCC and 154 without HCC. Specific NS5A mutations significantly correlate with HCC: S3T (8.8% vs. 1.3%, p = 0.01), T122M (8.8% vs. 0.0%, p < 0.001), M133I (20.6% vs. 3.9%, p < 0.001), and Q181E (11.8% vs. 0.6%, p < 0.001). By multivariable analysis, the presence of >1 of them independently correlates with HCC (OR (95%CI): 21.8 (5.7–82.3); p < 0.001). Focusing on HCC-group, the presence of these mutations correlates with higher viremia (median (IQR): 5.7 (5.4–6.2) log IU/mL vs. 5.3 (4.4–5.6) log IU/mL, p = 0.02) and lower ALT (35 (30–71) vs. 83 (48–108) U/L, p = 0.004), suggesting a role in enhancing viral fitness without affecting necroinflammation. Notably, these mutations reside in NS5A regions known to interact with cellular proteins crucial for cell-cycle regulation (p53, p85-PIK3, and β-catenin), and introduce additional phosphorylation sites, a phenomenon known to ameliorate NS5A interaction with cellular proteins. Overall, these results provide a focus for further investigations on molecular bases of HCV-mediated oncogenesis. The role of theseNS5A domain-1 mutations in triggering pro-oncogenic stimuli that can persist also despite achievement of sustained virological response deserves further investigation.

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Hepatocellular Carcinoma Recurrence in HCV Patients Treated with Direct Antiviral Agents

Cited by 16 publications

References 68 publications

Antiviral therapy in the palliative setting of HCC (BCLC-B and -C)

Antiviral therapy in the palliative setting of HCC (BCLC-B and -C)

Timing disparity of hepatocellular carcinoma (HCC) recurrence in a patient receiving interferon and subsequent direct antiviral agent (DAA) therapy for chronic hepatitis C

Genetic Determinants in a Critical Domain of NS5A Correlate with Hepatocellular Carcinoma in Cirrhotic Patients Infected with HCV Genotype 1b

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