Recurrence rate of hepatocellular carcinoma in patients with treated hepatocellular carcinoma and hepatitis C virus‐associated cirrhosis after ombitasvir/paritaprevir/ritonavir+dasabuvir+ribavirin therapy

Abstract

Introduction: Recent studies have suggested a higher recurrence rate of hepatocellular carcinoma (HCC) in patients with a history of HCC and hepatitis C virus (HCV)-associated cirrhosis treated with direct-acting antiviral (DAA) agents. Material and methods: We conducted a prospective analysis of 24 patients with HCV-associated cirrhosis and treated HCC who received ombitasvir/paritaprevir/ritonavirþdasabuvirþribavirin for 12 weeks. Prior therapies for HCC included resection (9/24 patients), radiofrequency ablation (RFA) (7/24) and trans-arterial chemoembolization (TACE) (8/24). All patients were eligible for treatment if they had no HCC recurrence 6 months after their last procedure. A control group was defined. All patients were followed every 6 months, with dynamic computed tomography and/or magnetic resonance imaging. Results: The sustained virological response rate per protocol was 21/24 (87.5%). The study group included 14 (59%) males, median age 64 years (51-77), 50% with associated non-alcoholic steatohepatitis and 24% with Child-Pugh A6 points. HCC recurrence rate/100 patient-years was lower in the DAA-HCC group versus control: 5.5 versus 24.6% patient-years for the resectionþRFA group (p ¼ 0.044), respectively, and 18.6 versus 72.7% patient-years for TACE group (p ¼ 0.002). Survival without recurrence was higher in the resectionþRFA group (45 compared to 18 months (p < 0.001)) and also in the TACE group (44 compared to 11.5 months (p ¼ 0.002)). Conclusions: DAA therapy significantly reduced the recurrence rate of HCC and improved survival without recurrence in patients with treated HCV-associated HCC.

Hepatocellular Carcinoma Recurrence after Hepatitis C Virus Therapy with Direct-Acting Antivirals. A Systematic Review and Meta-Analysis

“…Overall, the search strategy identified 337 studies, of which 61 were considered for inclusion. After excluding 15 studies presenting data on HCC occurrence and not recurrence, 10 reporting incomplete data, and 5 focusing on post-transplantation HCC recurrence, 31 studies were finally included in the present systematic review [ 8 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ] ( Figure 1 ), encompassing 2957 patients and 32 cohorts, as the ANRS study included two patient groups [ 14 ].…”

Efficacy and Safety of Ledispavir/Sofosbuvir with or without Ribavirin in patients with Decompensated Liver Cirrhosis and Hepatitis C Infection: a Cohort Study

“…Hepatitis C virus (HCV) is an epidemic problem worldwide, a f f e c t i n g a p p r o x i m a t e l y 71 million people [1,2]. In R o m a n i a , t h e e s t i m a t e d prevalence of chronic HCV according to data published in 2010 was approximately 4% [3], but it is decreasing now due to reimbursed direct directantiviral agents (DAAs), received by approximately 35,000 patients with more than a 96% sustained virologic response (SVR) rate [4][5][6]. In Romania, genotype 1b is almost exclusively present among the infected patients [7].…”

Hepatocellular Carcinoma and Antiviral Therapies in HCV Chronic Infection

“…The SVR rate in the study group was 87% (lower than that recorded in patients without HCC). [98] Another prospective study on 278 patients with HCV related advanced fibrosis (F3-F4), without HCC history, revealed 11 cases on newly diagnosed HCC (5 during antiviral therapy, 2 at the end of therpy and 4 at 3 months after the end of therapy). The overall incidence of HCC did not surpass the general incidence.…”