Occurrence of hepatocellular carcinoma after direct-acting antiviral therapy for hepatitis C virus infection: literature review and risk analysis. Issue 7 (3rd July 2019)

• Record Type: Journal Article
• Authors: Galati, Giovanni; Muley, Moises; Viganò, Mauro; Iavarone, Massimo; Vitale, Alessandro; Dell'Unto, Chiara; Lai, Quirino; Cabibbo, Giuseppe; Sacco, Rodolfo; Villa, Erica; Trevisani, Franco
• Is Part Of: Expert opinion on drug safety. Volume 18:Issue 7(2019)
• Page Start: 603
• Page End: 610
• Publication Date: 2019-07-03
• Subjects: Hepatocellular carcinoma -- HCC -- HCV -- DAA/direct-acting antivirals -- occurrence; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2019.1617272
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Introduction : Concerns were raised about a high occurrence of hepatocellular carcinoma (HCC) after successful treatment of chronic hepatitis C (CHC) by direct-acting antivirals (DAAs). Areas covered : The authors summarize the clinical studies reporting the occurrence rate and risk factors of HCC after DAAs in CHC. Expert opinion : The recent introduction of all-oral DAAs has substantially changed the scenario of CHC, achieving a sustained virological response (SVR) in >90% of cases. Earlier concerns raised about an increasing incidence of HCC post-DAAs were flawed by large heterogeneity of patients, the limited number of well-designed prospective studies (only nine, up to date) and the inclusion of a large number of patients with advanced liver disease, previously excluded from interferon-based studies. Current data on DAAs have shown a lower risk of HCC development; however, they were unable to identify patients at greater risk for HCC occurrence after SVR. Surveillance strategy, likely lifelong, is mandatory in these patients according to general expert opinion.