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Is There a Relationship Between Treatment With Direct Antiviral Agents for HCV Infection and the Development of
Tarek Saadi1,2,3, Johad Khoury1,4
1Liver Unit.
Background And Aims:
Direct antiviral agents (DAAs) have become the treatment of choice for patients with chronic hepatitis C virus (HCV) infection. As these drugs are new, it is important to learn the adverse events of these drugs in the short and long terms. We report on 7 patients who developed malignancies during treatment with DAAs or a short time after finishing treatment.
Methods:
We treated 133 patients with DAAs in our unit between January 2015 and June 2016, 100 (75%) of whom were treated with the combination of paritaprevir/ritonavir/ombitasvir with/without dasabuvir (PrOD). The distribution of HCV genotypes was as follow: G1b 114 (85.7%), G1a 3 (2.2%), G2 3 (2.2%), G3 10 (7.5%), G4 2 (1.5%). One hundred ten (82.7%) patients finished treatment. Adverse events were recorded during treatment and after finishing treatment. Efficacy was determined by assessment of serum HCV RNA.
Results:
We observed malignancies in 7 patients: 1 developed laryngeal carcinoma, 1 developed pancreatic adenocarcinoma, 1 developed oropharyngeal lymphoma, 1 developed recurrent aggressive transitional cell carcinoma of the urinary bladder, 1 developed recurrent aggressive hepatocellular carcinoma, and 2 patients developed de novo hepatocellular carcinoma. All of these patients had advanced liver disease.
Conclusions:
This report raises questions about DAAs and the possible development of malignancies. It will be important to look at large clinical trial data and real-world experience to determine if this relationship is real.
Insights
Direct antiviral agents (DAAs) for hepatitis C virus (HCV) infection were associated with new malignancies in 7 patients. Further research is needed to confirm if this link between DAAs and cancer is real.
Area of Science:
- Hepatology
- Oncology
- Pharmacology
Background:
- Direct antiviral agents (DAAs) are the preferred treatment for chronic hepatitis C virus (HCV) infection.
- The long-term adverse events of these novel DAAs require thorough investigation.
- This study reports on malignancies observed in patients undergoing DAA treatment.
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