Article: Incidence of hepatocellular carcinoma after direct antiviral therapy for HCV in patients with cirrhosis included in surveillance programs—P. Nahom, et al.
Source: Gastroenterol. 2018;doi:10.1016/j.gastro.2018.07.015.
Study Aims and Results: The study analyzed records of 1,270 chronic hepatitis C (HCV) patients with biopsy-proven compensated cirrhosis from 2006 through 2012 at 35 centers in France. The patient records were divided into three groups:
- Patients treated with direct-acting antiviral (DAA therapy and were cured (336 patients),
- Patients were treated with interferon-based therapy and were cured (495 patients), and
- Patients never received DAA therapy and who never had a cure following interferon treatment (439 patients).
The study participants were included in a liver cancer surveillance program with ultrasound exams every six months, and their clinical and biological data were collected.
The patient characteristics in the DAA group were older, had higher proportions of diabetes or portal hypertension (high blood pressure in the liver), and severely impaired liver function. These health markers are predictive of more severe liver disease progression that may lead to liver cancer.
The 3-year incidence of liver cancer was 5.9% in the DAA group, 3.1% in the interferon-cured group and 12.7% in the non-cure group. Importantly, the DAA group had the least amount of liver cancer screening compared to the other two groups.
Conclusions: The authors’ concluded that the slightly higher rates of liver cancer in the DAA group can be explained by the patient characteristics (older age, a higher proportion of diabetes or portal hypertension, and severely impaired liver function) and the lower cancer screening rate.
Editorial Comments: The findings in this study (treatment with DAAs in people with more severe disease) with outcomes of more liver cancer makes sense. However, more studies are needed that have similar patient populations are to confirm these findings.Share This Page