Hepatitis C Virus Cure Rates Are Reduced in Patients With Active but Not Inactive Hepatocellular Carcinoma: A...

Area of Science:

• Hepatology
• Virology
• Oncology

Background:

• Direct-acting antivirals (DAAs) offer high cure rates for Hepatitis C Virus (HCV).
• Limited data exist on DAA efficacy in patients with Hepatocellular Carcinoma (HCC), particularly differentiating between active and inactive disease.
• Real-world data are crucial for understanding treatment outcomes in diverse patient populations.

Purpose of the Study:

• To compare DAA treatment outcomes in patients with HCV and HCC versus those with HCV but without HCC.
• To evaluate the impact of active versus inactive HCC on DAA treatment efficacy.
• To assess sustained virologic response (SVR) rates and safety profiles in these groups.

Main Methods:

• Utilized propensity score matching (PSM) on data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry.
• Matched 436 pairs of patients with HCC and non-HCC based on key demographic and clinical characteristics.
• Analyzed sustained virologic response (SVR) rates, treatment discontinuation, adverse events, and mortality.

Main Results:

• Overall SVR rates were high and comparable between HCC (92.7%) and non-HCC (95.0%) groups post-PSM.
• Patients with active HCC had significantly lower SVR rates (85.5%) compared to inactive HCC (93.7%).
• Treatment discontinuation, adverse events, and mortality rates were similar across groups.

Conclusions:

• Active HCC, but not inactive HCC, was independently associated with lower SVR rates compared to non-HCC patients receiving DAA therapy.
• Despite lower rates, DAA therapy still achieved a relatively high cure rate (85%) in patients with active HCC.
• DAA treatment is effective for HCV in patients with HCC, with disease activity being a key factor influencing outcomes.