Impact of successful HCV treatment using direct acting antivirals on recurrence of well ablated hepatocellular carcinoma

• Published in: Expert review of anti-infective therapy Vol. 20; no. 2; p. 307
• Main Authors: Elbaz, Tamer, Waked, Imam, El-Akel, Wafaa, Shaker, Mohamed Kamal, Abdelaziz, Ashraf Omar, Yousif, Monkez, El-Bendary, Mahmoud, Zaky, Samy, AbdAllah, Mohamed, Hassany, Mohamed, Esmat, Gamal, Doss, Wahid
• Format: Journal Article
• Language: English
• Published: England 01.02.2022
• Subjects: Antiviral Agents - therapeutic use; Carcinoma, Hepatocellular - drug therapy; Hepacivirus - genetics; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C, Chronic - drug therapy; Humans; Liver Neoplasms - drug therapy; Middle Aged; Retrospective Studies; recurrence; daas; HCC; HCV; SVR
• ISSN: 1744-8336
• DOI: 10.1080/14787210.2021.1951230

There are many contradictory studies that dealt with hepatocellular carcinoma (HCC) recurrence rate of well ablated hepatitis C virus (HCV) related HCC. We aim to assess the recurrence rate of previously ablated HCC in patients who received direct acting antiviral (DAA) for their HCV. This is a retrospective data analysis of 523 HCV patients who have a history of successfully ablated HCC and eligible for HCV treatment. Retrieval was done to demographic/clinical data, HCV pretreatment investigations, HCV treatment outcome. Follow up for survival and HCC recurrence was done every 3 months using abdominal ultrasound and alfa-fetoprotein. Mean age was 53.83 years. Sofosbuvir/daclatasvir/ribavirin was the most used regimen (35.4%) with 438 patients (83.7%) achieved sustained virologic response (SVR). The median duration for surveillance was 159 weeks. Hundred and five patients developed recurrent HCC, with a crude recurrence rate of 20.1%. There was no difference between HCV responders and non-responders in crude recurrence rate (p = 0.94) but HCC developed earlier in non-responders (p = <0.01). Recurrence of HCC remains a threat in HCV patients even after achieving an SVR. Implementation of long-term surveillance programs is highly recommended.