Hepatitis C Virus Cure Rates Are Reduced in Patients With Active but Not Inactive Hepatocellular Carcinoma: A Practice Implication. (28th November 2019)

• Record Type: Journal Article
• Authors: Ogawa, Eiichi; Toyoda, Hidenori; Iio, Etsuko; Jun, Dae Won; Huang, Chung-Feng; Enomoto, Masaru; Hsu, Yao-Chun; Haga, Hiroaki; Iwane, Shinji; Wong, Grace; Lee, Dong Hyun; Tada, Toshifumi; Liu, Chen-Hua; Chuang, Wan-Long; Hayashi, Jun; Cheung, Ramsey; Yasuda, Satoshi; Tseng, Cheng-Hao; Takahashi, Hirokazu; Tran, Sally; Yeo, Yee Hui; Henry, Linda; Barnett, Scott D; Nomura, Hideyuki; Nakamuta, Makoto; Dai, Chia-Yen; Huang, Jee-Fu; Yang, Hwai-I; Lee, Mei-Hsuan; Jun, Mi Jung; Kao, Jia-Horng; Eguchi, Yuichiro; Ueno, Yoshiyuki; Tamori, Akihiro; Furusyo, Norihiro; Yu, Ming-Lung; Tanaka, Yasuhito; Nguyen, Mindie H;
• Is Part Of: Clinical infectious diseases. Volume 71:Number 11(2020)
• Page Start: 2840
• Page End: 2848
• Publication Date: 2019-11-28
• Subjects: hepatitis C virus -- hepatocellular carcinoma -- direct-acting antivirals -- Asian -- propensity score matching; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciz1160
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCC patients. Methods: Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCC patients. Results: We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = . 03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC. Conclusions: Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCC patients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCC patients. Abstract : We found no significant difference in treatment tolerability or completion rate between DAA-treated patients with and without Hepatocellular Carcinoma (HCC). Non-HCC and inactive HCC patients had similar cure rate (95%) but not active HCC (85%), an independent risk factor for lower SVR.