z-logo
Premium
Increased incidence of liver cancer after successful DAA treatment of chronic hepatitis C: Fact or fiction?
Author(s) -
Alberti Alfredo,
Piovesan Sara
Publication year - 2017
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13390
Subject(s) - hepatocellular carcinoma , medicine , cirrhosis , incidence (geometry) , hepatitis c , liver cancer , cancer , hepatocellular cancer , antiviral therapy , homogeneous , gastroenterology , chronic hepatitis , oncology , immunology , virus , physics , optics , thermodynamics
Therapy of hepatitis C has been revolutionized by Direct Antiviral Agents. These drugs are safe and efficacious in all infected patients, including those with advanced, or decompensated cirrhosis, and are currently largely used in such cases in clinical practice worldwide. It was therefore cause of great concern the publication of two reports suggesting that treatment with DAA s could increase the risk of hepatocellular carcinoma in cirrhotic patients, particularly in those receiving antiviral therapy after having been cured for an HCC . These reports have generated a great and controversial debate and have been followed by a series of other publications not confirming such increased risk. This article summarizes published studies assessing the relation between DAA therapy and HCC in two different clinical setting: HCC recurrence in patients with an history of cured HCC and “de novo” HCC occurrence in patients without previous HCC . Rates of HCC recurrence after DAA s were extremely variable in different studies, reflecting great heterogeneity of this clinical setting. Data on “de novo” HCC incidence were more homogeneous and suggest that treatment with DAA s is not modifying the risk of developing HCC in the first 6‐12 months. The possibility that treatment with DAA s may favour tumour growth and spread in individual patients with active HCC foci is suggested by some observations but remains unproven. There is clearly a need for prospective studies designed to better define these issues.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here