Comparison of the efficacy and safety of direct-acting antiviral therapy with or without hepatitis C-related hepatocellular carcinoma.
BACKGROUND/AIMS
Chronic hepatitis C (CHC) treatment has dramatically improved since direct-acting antiviral (DAA) therapy was introduced. However, the use of DAA therapy in CHC patients with hepatocellular carcinoma (HCC) remains controversial. We investigated the DAA treatment response in CHC patients with HCC.


METHODS
We retrospectively analyzed CHC patients treated with DAA from 2016 to 2018. Patients were divided into two groups based on their HCC-history before DAA therapy. Baseline characteristics, sustained virologic response at 12 weeks (SVR 12), and HCC recurrence after DAA therapy were evaluated. We also used propensity score matching (PSM) in a 2:1 ratio to reduce confounding variables.


RESULTS
A total of 192 patients were enrolled; 78.1% were treatment-naïve, and 34.9% had liver cirrhosis (LC). Among these patients, 168 did not have HCC, and 24 had HCC. The HCC group was older (57.0 years vs. 72.0 years, p < 0.001), had a higher incidence of LC (26.2% vs. 95.8%, p < 0.001), fibrosis-4 index (2.6 vs. 9.2, p < 0.001), liver stiffness measurement (7.0 kPa vs. 17.4 kPa, p = 0.012), and α-fetoprotein (4.4 ng/mL vs. 8.2 ng/mL, p ≤ 0.001). The SVR 12 rate was 97.0% in the non- HCC group and 91.7% in the HCC group (p = 0.213). HCC recurrence was observed in 14 patients (58.3%) in the HCC group.


CONCLUSION
DAA treatment efficacy in CHC patients with or those without HCC were not significantly different, and HCC recurrence was relatively common.
['Kwan|Byung Soo|BS|', 'Kim|Jeong Han|JH|', 'Park|Seong Jun|SJ|', 'Choe|Won Hyeok|WH|', 'Kwon|So Young|SY|', 'Yoo|Byung-Chul|BC|']
D000998:Antiviral Agents D006528:Carcinoma, Hepatocellular D019698:Hepatitis C, Chronic D006801:Humans D008113:Liver Neoplasms D009364:Neoplasm Recurrence, Local D012189:Retrospective Studies
Hepatocellular carcinoma Chronic hepatitis C Direct-acting
 antiviral Hepatitis C virus