Response rates to direct antiviral agents among hepatitis C virus infected patients who develop hepatocellular carcinoma following direct antiviral agents treatment

• 作者: Alessandro Croce Carlo Smirne Cristina Rigamonti Elisa Ceriani Mario Pirisi Michela Emma Burlone Paolo Ravanini Rachele Rapetti Rosalba Minisini Stefano Fangazio Stelvio Tonello
• 来源期刊: 肝癌研究（英文版）
• 年，卷（期）: 2020,（2）
• 页码范围: 1-10
• 页数: 10页
• 语种: 英文
• DOI: 10.20517/2394-5079.2019.37

摘要

Aim: Patients with chronic hepatitis C virus (HCV) infection who develop hepatocellular carcinoma (HCC) soon after treatment with direct antiviral agents (DAA) may have been harboring hitherto hidden tumors. If this were true, they should have a lower sustained viral response (SVR) rate, since active HCC hampers DAA efficacy. We aimed to verify this hypothesis.Methods: We included all patients who attended an HCV clinic, provided that they: (1) had no previous history of HCC; (2) had received at least one DAA dose; and (3) had been followed-up clinically and ultrasonographically for at least six months after concluding DAA. Results: The study population included n = 789 patients (55％ males, median age 62 years). A median of 9.3 months (8.8-11.9) after concluding DAA, n = 19 (2.4％) patients were discovered to harbor HCC. In comparison to all others, patients with HCC were more commonly male (84％ vs. 54％, P = 0.009), obese (47％ vs. 17％, P = 0.002), and cirrhotic (95％ vs. 35％, P < 0.001) and had less commonly achieved an SVR (68％ vs. 98％, P < 0.001). Moreover, they had a trend for being less commonly treatment na?ve (58％ vs. 67％, P = 0.051). Based on multivariate analysis,&nbsp;the independent predictors of HCC were male sex (P = 0.031), cirrhosis (P = 0.004), obesity (P = 0.006), and failure to achieve an SVR (P < 0.001).Conclusion: Lack of achieving SVR is a strong independent predictor of development of HCC early after treatment of hepatitis C with DAA. Treatment failure should further alert clinicians to the possibility of this dreadful complication.