Reuters Health Information: High rates of hepatocellular carcinoma after hepatitis C treatment
High rates of hepatocellular carcinoma after hepatitis C treatment
Last Updated: 2017-02-07
By Will Boggs MD
NEW YORK (Reuters Health) Patients treated with
direct-acting antiviral (DAA) therapy for hepatitis C virus
(HCV)-related cirrhosis appear to have high rates of
hepatocellular carcinoma (HCC).
If these findings are confirmed from other centers, studies
are suggested to examine mechanisms of these findings, Dr.
Ashwani Singal from University of Alabama at Birmingham told
Reuters Health by email.
Some studies have shown unexpectedly high HCC recurrence
rates after DAA therapy, whereas others have shown no such
Dr. Singal and colleagues examined the occurrence of de novo
HCC in their retrospective study of 66 patients with HCV-related
cirrhosis who received DAA between 2015 and 2016.
Typically, patients with HCV cirrhosis have an HCC incidence
of 3%-5% per year, the researchers say.
But six of these patients (9.1%) developed HCC during or
within six months after treatment, and two additional patients
(3%) developed indeterminate liver lesions, according to their
letter online February 1st in Gastroenterology.
They note that another study showed a reduced risk of HCC
occurrence among DAA-treated patients who achieved sustained
viral responses (SVR) versus those not achieving SVR, so they
suggest prospective multicenter studies to confirm these
Be aware of this potential issue and consider more
intensive HCC surveillance of HCV cirrhotics during and after
HCV therapy, Dr. Singal concluded.
Dr. Gaetano Serviddio from University of Foggia, Italy, who
has reported on the outcomes of DAA therapy, told Reuters Health
by email, DAAs have completely changed the prognosis of chronic
hepatitis C patients who have a unique possibility to be cured
definitively. To discover that such drugs have some tumor risks
is particularly terrible. In any case, the number of events is
small, and the data are not enough to support the hypothesis
that the risk is directly related to the drugs.
DAAs are safe and powerful drugs; millions of lives will be
saved with such drugs, he said. Studies should be supported to
completely define patients at risk of HCC recurrence.