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The impact of interferon‐free direct‐acting antivirals on clinical outcome after curative treatment for hepatitis C virus–associated hepatocellular carcinoma: Comparison with interferon‐based therapy
Author(s) -
Nagaoki Yuko,
Imamura Michio,
Nishida Yuno,
Daijo Kana,
Teraoka Yuji,
Honda Fumi,
Nakamura Yuki,
Morio Kei,
Fujino Hatsue,
Nakahara Takashi,
Kawaoka Tomokazu,
Tsuge Masataka,
Hiramatsu Akira,
Kawakami Yoshiiku,
Miki Daiki,
Hiyama Yuichi,
Ochi Hidenori,
Chayama Kazuaki,
Aikata Hiroshi
Publication year - 2019
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.25352
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , propensity score matching , hazard ratio , hepatitis c virus , multivariate analysis , retrospective cohort study , interferon , proportional hazards model , hepatology , hepatitis c , cohort , oncology , immunology , virus , confidence interval
Background and Aim To examine the effect on recurrence and survival of treatment by interferon (IFN)‐free direct‐acting antivirals (DAA) for patients with hepatitis C virus (HCV)‐associated hepatocellular carcinoma (HCC) who underwent primary curative treatment. Methods This was a retrospective cohort study of 250 patients with HCV who had received curative treatment for primary HCC. As anti‐HCV treatment after HCC treatment, 38 patients received IFN‐free DAA therapy (DAA patients) and 94 received IFN‐based therapy (IFN patients). The recurrence of HCC and overall survival of the patient groups were compared in a case‐control study. Results The cumulative HCC recurrence rates at 1, 3, and 5 years were 5%, 39%, and 39% for DAA patients and 0%, 46%, and 62% for IFN patients, respectively ( P = 0.370). Multivariate analysis of the HCC recurrence identified treatment responses (sustained virological response [SVR]: hazard ratio [HR] 2.237; P = 0.003) as an independent predictive factor. The cumulative overall survival rates at 3 and 5 years were 96%, 96% for DAA patients and 93%, 73% for IFN patients, respectively ( P = 0.163). Multivariate analysis identified treatment responses (SVR: HR 8.742; P < 0.001) as independent predictors of overall survival. Propensity score matching analysis showed no significant difference in HCC development rates and overall survival rates in the two groups. Conclusions We found that SVR obtained after curative treatment for primary HCC suppressed recurrence and improved overall survival. And, IFN‐free DAA therapy after curative treatment for primary HCC could predict improving overall survival and suppressed HCC recurrence.