scholarly journals Past history of hepatocellular carcinoma is an independent risk factor of treatment failure in patients with chronic hepatitis C virus infection receiving direct-acting antivirals

2018 ◽  
Vol 25 (12) ◽  
pp. 1462-1471 ◽  
Author(s):  
Ayumi Sugiura ◽  
Satoru Joshita ◽  
Takeji Umemura ◽  
Tomoo Yamazaki ◽  
Naoyuki Fujimori ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Past History ◽  
Hepatitis C Virus Infection ◽  
Direct Acting Antivirals ◽  
Chronic Hepatitis C Virus ◽  
History Of ◽  
Direct Acting

Early occurrence of hepatocellular carcinoma in patients with and without cirrhosis after HCV treatment with direct-acting antivirals.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 356-356
Author(s):  
Fabian Finkelmeier ◽  
Georg Dultz ◽  
Bernd Kronenberger ◽  
Kai Henrik Peiffer ◽  
Franziska Krauss ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
De Novo ◽  
Direct Acting Antivirals ◽  
Historical Cohort ◽  
Comparison Results ◽  
Cirrhotic Patients ◽  
Direct Acting

356 Background: The aim of the study was to evaluate the risk of HCC development after treatment with direct-acting antivirals (DAA) and to compare hepatocellular carcinoma (HCC) occurrence to patients treated with interferon (IFN)-based therapies. Methods: We analyzed a large cohort with chronic HCV patients for the onset of new hepatocellular carcinoma after DAA treatment. A historic interferon treated cohort was investigated for comparison. Results: 819 patients were included in the DAA group, 269 (32.8%) had established cirrhosis. Median follow up was 263 days (0-1001). 25 patients (3.1%) were diagnosed with de novo HCC within the observation time. All of these patients had established cirrhosis. Patients with new HCC were mostly male, older, treatment experienced, had a lower SVR12 rate and higher levels of liver inflammation markers. Investigation of the subcohort of 269 cirrhotic patients yielded a HCC rate of 9.3% during the follow-up of approximately one year. Non-SVR12 was an independent risk factor for de novo HCC (OR 4.983, 1.39-17.88, 0.014). Most HCCs were diagnosed in early stage BCLC A. In the historical cohort of 351 IFN treated patients the rate of de novo HCC was 5.4% overall and 11.8% in patients with already established cirrhosis (n = 68). In the multivariate analysis failed SVR (OR 5.386, 1.155-25.108, p = 0.032) remained an independent risk factor for de novo HCC. In a combined analysis of all patients (DAA and IFN treated) in a multivariate approach male gender, failed SVR and cirrhosis were independent factors for HCC development. Conclusions: DAA treatment in cirrhotic patients does not seem to reduce the risk of HCC development in the short term. HCC rates were not different between DAA-treated patients and those who received interferon. Achievement of SVR seems to be the most important aim to prevent HCC development.

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