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Prognosis of Patients with Chronic Hepatitis C Genotype 1b Infection Treated Using Daclatasvir/Asunaprevir after

Jae-Hyun Yoon1, Sung-Eun Kim2, Su-Hyeon Cho1

  • 1Department of Internal Medicine, School of Medicine, Chonnam National University Hospital, Gwangju 61469, Republic of Korea.

Medicina (Kaunas, Lithuania)
|August 26, 2023
PubMed

Insights

Patients treated with daclatasvir/asunaprevir for chronic hepatitis C achieved sustained virologic response, but a risk of hepatocellular carcinoma remains. Older age and cirrhosis are key risk factors for developing liver cancer post-treatment.

Area of Science:

  • Hepatology
  • Virology
  • Oncology

Background:

  • Direct-acting antiviral (DAA) therapy offers a cure for chronic hepatitis C (CHC).
  • Daclatasvir (DCV)/asunaprevir (ASV) was the first interferon-free DAA regimen available in Korea.
  • Sustained virologic response (SVR) after DAA treatment is associated with favorable patient prognoses.

Purpose of the Study:

  • To investigate the long-term prognosis of patients with CHC who achieved SVR after DCV/ASV treatment.
  • To identify risk factors for hepatocellular carcinoma (HCC) development in this patient cohort.

Main Methods:

  • A multicenter prospective observational study was conducted.
  • 302 patients with CHC who achieved SVR following DCV/ASV therapy were included.
  • Hepatocellular carcinoma (HCC) occurrence was the primary endpoint, monitored annually over a median follow-up of 38 months.

Main Results:

  • Hepatocellular carcinoma (HCC) developed in 5.3% of patients within six years post-SVR.
  • Patients who developed HCC were older and had higher rates of cirrhosis, elevated alpha-fetoprotein, and higher FIB-4 scores.
  • Cox proportional hazards analysis identified age > 71 years and the presence of cirrhosis as significant risk factors for HCC (p=0.005 and p=0.035, respectively).

Conclusions:

  • While DCV/ASV therapy leads to good prognoses for CHC patients achieving SVR, a residual risk of HCC exists.
  • Older age and pre-existing cirrhosis are critical factors increasing HCC risk after treatment.
  • Recommendations include initiating treatment at younger ages and implementing regular post-SVR surveillance for HCC.

Keywords:
antiviral agentshepatitis Chepatocellular carcinomaliver cirrhosissustained virologic response

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