Recurrence rate of hepatocellular carcinoma in patients with treated hepatocellular carcinoma and hepatitis C virus-associated cirrhosis after ombitasvir/paritaprevir/ritonavir+dasabuvir+ribavirin therapy. Issue 5 (June 2019)

• Record Type: Journal Article
• Authors: Preda, Carmen M; Baicus, Cristian; Sandra, Irina; Oproiu, Alexandru; Manuc, Teodora; Constantinescu, Ileana; Gavrila, Daniel; Diculescu, Mircea; Dumitru, Radu; Vasilescu, Catalin; Tieranu, Cristian; Istratescu, Doina; Voiosu, Theodor; Manuc, Mircea
• Is Part Of: United European Gastroenterology journal. Volume 7:Issue 5(2019)
• Page Start: 699
• Page End: 708
• Publication Date: 2019-06
• Subjects: Hepatitis C -- direct antiviral therapy -- hepatocellular carcinoma -- ombitasvir/paritaprevir/r+dasabuvir+ribavirin -- liver cirrhosis; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640619841254
• Languages: English
• ISSNs: 2050-6406

Abstract

Introduction: Recent studies have suggested a higher recurrence rate of hepatocellular carcinoma (HCC) in patients with a history of HCC and hepatitis C virus (HCV)-associated cirrhosis treated with direct-acting antiviral (DAA) agents. Material and methods: We conducted a prospective analysis of 24 patients with HCV-associated cirrhosis and treated HCC who received ombitasvir/paritaprevir/ritonavir+dasabuvir+ribavirin for 12 weeks. Prior therapies for HCC included resection (9/24 patients), radiofrequency ablation (RFA) (7/24) and trans-arterial chemoembolization (TACE) (8/24). All patients were eligible for treatment if they had no HCC recurrence 6 months after their last procedure. A control group was defined. All patients were followed every 6 months, with dynamic computed tomography and/or magnetic resonance imaging. Results: The sustained virological response rate per protocol was 21/24 (87.5%). The study group included 14 (59%) males, median age 64 years (51–77), 50% with associated non-alcoholic steatohepatitis and 24% with Child–Pugh A6 points. HCC recurrence rate/100 patient-years was lower in the DAA-HCC group versus control: 5.5 versus 24.6% patient-years for the resection+RFA group ( p = 0.044), respectively, and 18.6 versus 72.7% patient-years for TACE group ( p = 0.002). Survival without recurrence was higher in the resection+RFA group (45 compared to 18 months ( p < 0.001)) and also in the TACE group (44 compared to 11.5 months ( p = 0.002)). Conclusions: DAA therapy significantly reduced the recurrence rate of HCC and improved survival without recurrence in patients with treated HCV-associated HCC.