Continued efforts are needed to aggressively screen, diagnose, and treat hepatocellular carcinoma (HCC) because patients with chronic hepatitis C and HCC may be less likely to achieve cure status than those without HCC, according to a systematic review and meta-analysis published in the Journal of Hepatology.1
Studies have demonstrated that antiviral therapy in patients with hepatitis B-related HCC can significantly reduce overall long-term mortality, even in patients with very advanced HCC or decompensated cirrhosis.2-5 Questions remain, however, about the effect of HCC on response to interferon-free direct-acting antiviral (DAA) therapy for patients with chronic hepatitis C compared with those without HCC.1 Therefore, researchers investigated the effect of DAA therapy on sustained virologic response (SVR) among 3341 patients with chronic hepatitis C and HCC and 35,701 patients with chronic hepatitis C but without HCC from 49 studies conducted in 15 countries. Overall, they found that SVR rates were lower in patients having chronic hepatitis C with HCC compared with patients diagnosed with chronic hepatitis C without HCC (89.6% vs 93.3%, P=.0012), which indicated a 4.8% SVR reduction. However, the largest SVR reduction (18.8%) occurred in patients with active/residual HCC compared with inactive/ablated HCC. Patients with HCC who had a prior liver transplant also had a higher SVR compared with patients with HCC who had not had a liver transplant (P <.001).