Premium
Low recurrence rate of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment in a real‐world chronic hepatitis C patients cohort
Author(s) -
Idilman Ramazan,
Demir Mehmet,
Aladag Murat,
Erol Cihan,
Cavus Bilger,
Iliaz Raim,
Koklu Hayrettin,
Cakaloglu Yilmaz,
Sahin Memduh,
Ersoz Galip,
Koksal İftihar,
Karasu Zeki,
Ozgenel Meric,
Turan İlker,
Gunduz Feyza,
Ataseven Huseyin,
Akdogan Meral,
Kiyici Murat,
Koksal Aydın Seref,
Akhan Sila,
Gunsar Fulya,
Tabak Fehmi,
Kaymakoglu Sabahattin,
Akarca Ulus S
Publication year - 2019
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13075
Subject(s) - medicine , sofosbuvir , hepatocellular carcinoma , gastroenterology , ribavirin , ledipasvir , tolerability , hepatitis c , liver transplantation , liver disease , cohort , chronic hepatitis , transplantation , adverse effect , immunology , virus
Summary The aims of the present study were to evaluate the efficacy and tolerability of ledipasvir/sofosbuvir ( LDV / SOF ) with or without ribavirin in the treatment of chronic hepatitis C ( CHC ) in patients with advanced liver disease and to analyse whether the use of LDV / SOF treatment is associated with a new occurrence of hepatocellular carcinoma ( HCC ) during and after LDV / SOF treatment. The Turkish Early Access Program provided LDV / SOF treatment to a total of 200 eligible CHC patients with advanced liver disease. The median follow‐up period was 22 months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response ( SVR 12) was 86.0% with ITT analysis. SVR 12 was similar among patients with Child‐Pugh classes A, B and C disease and transplant recipients. From baseline to SVR 12, serum ALT level and MELD score were significantly improved ( P < 0.001). LDV / SOF treatment was generally well tolerated. Only one patient developed a new diagnosed HCC . Seventeen of the 35 patients, who had a history of previous HCC , developed HCC recurrence during the LDV / SOF treatment or by a median follow‐up of 6 months after treatment. HCC recurrence was less commonly observed in patients who received curative treatment for HCC compared with those patients who received noncurative treatment ( P = 0.007). In conclusion, LDV / SOF with or without ribavirin is an effective and tolerable treatment in CHC patients with advanced liver disease. Eradication is associated with improvements in liver function and a reduced risk of developing a new occurrence of HCC .