Interferon-free cure of hepatitis C virus infection does alter the soluble inflammatory milieu which could affect hepatocellular carcinoma surveillance by CD8+ T cells in patients with liver cirrhosis

Impact of direct acting antivirals on occurrence and recurrence of hepatocellular carcinoma: Biologically plausible or an epiphenomenon?

“…An experimental study analyzing the soluble inflammatory milieu from plasma cells of cirrhotic HCV patients found that HCV specific CD8+ T cells failed to recover from the baseline after DAA therapy. These cells play a role in HCC surveillance; therefore, their reduced activity in IFN free therapy could potentially affect development of HCC[ 19 ]. Furthermore, serum levels of microRNA (miRNA) 122 were found to be reduced in DAA treated HCV patients after achieving SVR[ 20 ].…”

“…Also, future investigations should be directed towards assessing the long-term effects of DAAs on these populations that have not been studied thus far[ 3 ]. In the meantime, a consensus recommendation seen in most of the studies at present is that even after achieving SVR, there should be close surveillance of patients with CHC especially with advance fibrosis and those who received a recent treatment for HCC in order to detect HCC at an early stage[ 18 , 19 , 26 , 32 ]. Some important Centers in Europe and United States have been delaying antiviral treatment for 6 mo or more after recent treatment for HCC in these patients.…”