Low recurrence rate of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment in a real‐world chronic hepatitis C patients cohort. Issue 6 (8th March 2019)

• Record Type: Journal Article
• Authors: Idilman, Ramazan; Demir, Mehmet; Aladag, Murat; Erol, Cihan; Cavus, Bilger; Iliaz, Raim; Koklu, Hayrettin; Cakaloglu, Yilmaz; Sahin, Memduh; Ersoz, Galip; Koksal, İftihar; Karasu, Zeki; Ozgenel, Meric; Turan, İlker; Gunduz, Feyza; Ataseven, Huseyin; Akdogan, Meral; Kiyici, Murat; Koksal, Aydın Seref; Akhan, Sila; Gunsar, Fulya; Tabak, Fehmi; Kaymakoglu, Sabahattin; Akarca, Ulus S
• Is Part Of: Journal of viral hepatitis. Volume 26:Issue 6(2019)
• Page Start: 666
• Page End: 674
• Publication Date: 2019-03-08
• Subjects: cirrhosis -- direct‐acting antivirals -- hepatitis C virus -- hepatocellular carcinoma -- liver transplantation; Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.13075
• Languages: English
• ISSNs: 1352-0504

Abstract

Summary: The aims of the present study were to evaluate the efficacy and tolerability of ledipasvir/sofosbuvir (LDV/SOF) with or without ribavirin in the treatment of chronic hepatitis C (CHC) in patients with advanced liver disease and to analyse whether the use of LDV/SOF treatment is associated with a new occurrence of hepatocellular carcinoma (HCC) during and after LDV/SOF treatment. The Turkish Early Access Program provided LDV/SOF treatment to a total of 200 eligible CHC patients with advanced liver disease. The median follow‐up period was 22 months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response (SVR12) was 86.0% with ITT analysis. SVR12 was similar among patients with Child‐Pugh classes A, B and C disease and transplant recipients. From baseline to SVR12, serum ALT level and MELD score were significantly improved ( P < 0.001). LDV/SOF treatment was generally well tolerated. Only one patient developed a new diagnosed HCC. Seventeen of the 35 patients, who had a history of previous HCC, developed HCC recurrence during the LDV/SOF treatment or by a median follow‐up of 6 months after treatment. HCC recurrence was less commonly observed in patients who received curative treatment for HCC compared with those patients who received noncurative treatment ( P = 0.007). In conclusion, LDV/SOF with or without ribavirin is an effective and tolerable treatment in CHC patients with advanced liver disease. Eradication is associated with improvements in liver function and a reduced risk of developing a new occurrence of HCC. Abstract : Ledipasvir and sofosbuvir with or without ribavirin is an effective and tolerable treatment in hepatitis C virus–infected patients with advanced liver disease. Eradication is associated with improvements in liver function and reduces the risk of developing a new occurrence of hepatocellular carcinoma.