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DIRECT-ACTING ANTIVIRALS FOR HEPATITIS C DO NOT AFFECT THE RISK OF DEVELOPMENT OR THE OUTCOME OF HEPATOCELLULAR
L Gogichaishvili1, G Lobjanidze1, T Tsertsvadze2
11Ivane Javakhishvili Tbilisi State University, Faculty of Medicine, Georgia.
Georgian Medical News
|November 1, 2020
Summary
Direct-acting antiviral (DAA) therapy effectively treats Hepatitis C virus (HCV) infection. This study found DAA regimens do not impact hepatocellular carcinoma (HCC) risk or mortality, making HCC not a contraindication for DAA treatment.
Area of Science:
- Hepatology
- Virology
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a major complication of Hepatitis C virus (HCV) infection.
- Georgia launched a nationwide HCV elimination program in 2015, including DAA treatment for HCC patients.
- The impact of different DAA regimens on HCC incidence, recurrence, and prognosis requires investigation.
Purpose of the Study:
- To evaluate the effect of various direct-acting antiviral (DAA) therapy regimens on the incidence or recurrence of hepatocellular carcinoma (HCC) in HCV patients.
- To assess the impact of DAA treatment on the prognosis of patients with HCV and HCC.
- To determine if HCC status is a contraindication for DAA treatment.
Main Methods:
- A cohort of 408 HCV patients aged 50-65 with advanced fibrosis (F3-F4) or cirrhosis were recruited between April 2015 and March 2016.
- Patients received DAA treatment according to national protocols, initially with sofosbuvir/ribavirin (±pegylated interferon), and later with ledipasvir/sofosbuvir (±ribavirin).
- Clinical and biological parameters were recorded, with regular monitoring for adverse events.
Main Results:
- No significant difference in HCC incidence or recurrence was observed across different DAA regimens or treatment durations.
- Mortality rates due to HCC did not significantly change between patient groups receiving different DAA therapies.
- DAA treatment was found to be safe and effective, regardless of HCC status, particularly in early-stage, curable cancers.
Conclusions:
- Direct-acting antiviral (DAA) regimens and treatment duration do not influence the risk of hepatocellular carcinoma (HCC) after antiviral therapy for Hepatitis C virus (HCV).
- Hepatocellular carcinoma (HCC) status is not a contraindication for direct-acting antiviral (DAA) treatment, especially for early-stage, curable cancers.
- The national HCV elimination program in Georgia demonstrates the feasibility of treating HCV patients, including those with HCC, using DAAs.
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