Antiviral Therapy Improves Hepatocellular Cancer Survival.

Area of Science:

• Hepatology
• Oncology
• Infectious Diseases

Background:

• Chronic hepatitis C virus (HCV) infection is a significant risk factor for hepatocellular cancer (HCC).
• HCV-induced liver fibrosis and cirrhosis increase the risk of developing HCC.
• Early HCV treatment and sustained virologic response (SVR) may reduce HCC incidence and mortality.

Purpose of the Study:

• To determine if HCV treatment impacts overall survival (OS) in patients who develop hepatocellular cancer (HCC).
• To compare survival outcomes between patients who achieved SVR and those who did not.
• To evaluate the influence of different HCV treatment regimens (interferon-based vs. direct-acting antiviral agents) on survival.

Main Methods:

• Retrospective review of 111 patients with HCV and HCC from November 2008 to March 2019.
• Analysis of patients treated with interferon-based regimens or direct-acting antiviral agents (DAAs).
• Multivariate analysis accounting for liver disease severity (MELD and Child-Pugh scores).

Main Results:

• HCV-treated patients showed improved 5-year OS (median 1338 days) compared to untreated patients (median 452 days).
• Patients achieving SVR had significantly increased 5-year OS (median 1973 days) versus those without SVR (median 470 days).
• Treatment type (DAA vs. interferon) did not significantly affect OS or progression-free survival (PFS); advanced liver disease was linked to worse outcomes.

Conclusions:

• HCV treatment confers an OS benefit for patients with HCC.
• Achieving SVR is associated with improved OS in HCC patients with prior HCV infection.
• The specific type of HCV treatment regimen did not demonstrate a significant survival advantage.