scholarly journals Hepatitis C Virus and Hepatocellular Carcinoma: Pathogenetic Mechanisms and Impact of Direct-Acting Antivirals

2018 ◽  
Vol 12 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Ivan Schietroma ◽  
Giuseppe Corano Scheri ◽  
Claudia Pinacchio ◽  
Maura Statzu ◽  
Arnolfo Petruzziello ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Infection ◽  
The United States ◽  
Epidemiological Studies ◽  
Direct Acting Antivirals ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Hcc Recurrence

Introduction:Globally, between 64 and 103 million people are chronically infected with Hepatitis C virus (HCV), with more than 4.6 million people in the United States and is associated with more than 15.000 deaths annually. Chronic infection can result in cirrhosis and hepatocellular carcinoma.Explanation:Epidemiological studies have indicated that persistent infection with hepatitis C virus (HCV) is a major risk for the development of hepatocellular carcinoma (HCC), mainly through chronic inflammation, cell deaths, and proliferation. Despite the new direct-acting antiviral drugs (DAA’s) being able to clear the HCV, HCC recurrence rate in these patients is still observed.Conclusion:In this review we highlighted some aspects that could be involved in the onset of HCV-induced HCC such as immune system, viral factors and host genetics factors.Moreover, we focused on some of the last reports about the effects of DAA’s on the HCV clearance and their potential implications in HCC recurrence.

scholarly journals Hepatocellular Carcinoma Recurrence after Hepatitis C Virus Therapy with Direct-Acting Antivirals. A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (8) ◽  
pp. 1694
Author(s):  
Leonardo Frazzoni ◽  
Usama Sikandar ◽  
Flavio Metelli ◽  
Sinan Sadalla ◽  
Giuseppe Mazzella ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Meta Analysis ◽  
Random Effect ◽  
Complete Response ◽  
Direct Acting Antivirals ◽  
Direct Acting ◽  
Hcc Recurrence

Background: Hepatocellular carcinoma (HCC) is a major cause of morbidity and mortality among patients with cirrhosis. The risk of HCC recurrence after a complete response among patients treated with direct-acting antivirals (DAAs) has not been fully elucidated yet. Aim: To assess the risk of HCC recurrence after DAA therapy for hepatitis C virus (HCV). Methods: A systematic review across PubMed, Scopus and Scholar up to November 2020, including full-text studies that assessed the pattern of HCC recurrence after DAA therapy for HCV. Random-effect meta-analysis and univariable metaregression were applied to obtain pooled estimates for proportions and relative risk (RR) and variables influential for the outcome, respectively. Results: Thirty-one studies with 2957 patients were included. Overall, 30% (CI, 26–34%) of the patients with a history of HCC experienced HCC recurrence after DAA therapy, at mean time intervals ranging from 4 to 21 months. This result increased when going from European studies (23%, CI, 17–28%) to US studies (34%, CI, 30–38%), to Egyptian studies (37%, CI, 27–47%), and to Asian studies (33%, CI, 27–40%). Sixty-eight percent (CI, 45–91%) of recurrent HCCs developed within 6 months of follow-up since DAA treatment, among the eight studies providing stratified data. Among the studies providing head-to-head comparisons, the HCC recurrence risk was significantly lower after DAA therapy than IFN (RR, 0.64; CI, 0.51–0.81), and after DAA therapy than no intervention (RR, 0.68; CI, 0.49–0.94). Conclusions: The recurrence of HCC after DAA is not negligible, being higher soon after the end of treatment and among non-European countries. DAA therapy seems to reduce the risk of HCC recurrence compared to an IFN regimen and no intervention.

scholarly journals Recent Advances in Antiviral Therapy for Chronic Hepatitis C

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Akihiro Tamori ◽  
Masaru Enomoto ◽  
Norifumi Kawada
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Trials ◽  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Failure ◽  
Chronic Infection ◽  
Direct Acting Antivirals ◽  
The Past ◽  
Direct Acting

Hepatitis C virus (HCV) infection is a major worldwide health problem. Chronic infection induces continuous inflammation in the liver, progression of hepatic fibrosis, eventual cirrhosis, and possible hepatocellular carcinoma. Eradication of the virus is one of the most important treatment aims. A number of promising new direct-acting antivirals (DAAs) have been developed over the past 10 years. Due to their increased efficacy, safety, and tolerability, interferon-free oral therapies with DAAs have been approved for patients with HCV, including those with cirrhosis. This review introduces the characteristics and results of recent clinical trials of several DAAs: NS3/4A protease inhibitors, NS5A inhibitors, and NS5B inhibitors. DAA treatment failure and prognosis after DAA therapy are also discussed.

Impact of Direct Acting Antiviral Therapy for Hepatitis C Virus Infection on Recurrence of Hepatitis C Virus Related Hepatocellular Carcinoma

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S M Ghaly ◽  
I A Mohamed ◽  
N I Musa ◽  
O A Ahmed ◽  
A S Abuhalima ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Recurrence Rate ◽  
Hcv Infection ◽  
Control Group ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Hcc Recurrence

Abstract Background hepatocellular carcinoma is the fifth most common tumor worldwide and the second most common cause of cancer-related death with a male-to-female predominance greater than 2:1. The presence of cirrhosis represents a key risk factor for the development of HCC. The prevalence of cirrhosis among patients with HCC has been estimated to be 85%-95% and the HCC incidence rate among patients with cirrhosis has been shown to be 2%-4% per year. HCV infection is a leading cause of liver cirrhosis and hence the development of HCC. Egypt has the highest HCV prevalence worldwide; with estimated rate of 10% of Egyptians between 15 – 59 years as reported by the Egyptian Health Issues Survey (EHIS) in 2015. Aim of the Work the aim of this study was to evaluate the impact of Direct Acting Antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection on recurrence of HCV related HCC after intervention. Patients and Methods this study was conducted on 50 patients with previously treated HCC who were treated for HCV infection using direct acting antiviral agents after confirming HCC regression and response to different treatment modalities and were followed for one year after antiviral treatment. A control group of another 50 patients with cured HCC who didn’t receive DAA therapy was included in the study to compare the recurrence rate in both groups and its relation to the antiviral therapy. Results the two groups didn’t differ as regards age, sex, biochemical profile, AFP, CBC and child score. The results of the study came to show an HCC recurrence rate of 38% in patients who received direct acting antiviral therapy after HCC intervention versus 62% in those who didn’t receive antiviral therapy. Conclusion direct acting antiviral drugs didn’t show to increase the risk of HCC recurrence in comparison to the control group. Yet it did not abolish it. So, close follow up of patients with HCC receiving antiviral therapy is highly recommended.

scholarly journals Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3414
Author(s):  
Hye Won Lee ◽  
Dai Hoon Han ◽  
Hye Jung Shin ◽  
Jae Seung Lee ◽  
Seung Up Kim ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Pegylated Interferon ◽  
Direct Acting Antivirals ◽  
Treatment Regimens ◽  
Direct Acting ◽  
Similar Risk ◽  
Carcinoma Risk

By pegylated interferon (PegIFN)-free direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection, a sustained virological response (SVR) rate >95% can be attained with a satisfactory tolerability and shorter treatment duration. However, it remains controversial whether there is any difference in prognosis depending on regimens—PegIFN or DAAs. We compared the probabilities of hepatocellular carcinoma (HCC) development between patients achieving an SVR by PegIFN/ribavirin (PegIFN group, n = 603) and DAAs (DAAs group, n = 479). The DAAs group was significantly older and had a higher proportion of cirrhosis than the PegIFN group. Before adjustment, the DAAs group had a higher HCC incidence than the PegIFN group (p < 0.001). However, by multivariate analyses, the DAAs (vs. PegIFN) group was not associated with HCC risk (adjusted hazard ratio 0.968, 95% confidence interval 0.380–2.468; p = 0.946). Old age, male, higher body mass index, cirrhosis, and lower platelet count were associated with increased HCC risk (all p < 0.05). After propensity score matching (PSM), a similar HCC risk between the two groups was observed (p = 0.372). We also compared HCC incidences according to sofosbuvir (SOF)-based and SOF-free DAAs, showing a similar risk in both groups before adjustment (p = 0.478) and after PSM (p = 0.855). In conclusion, post-SVR HCC risks were comparable according to treatment regimens; PegIFN- vs. DAA-based regimens and SOF-based vs. SOF-free DAA regimens. Further studies with a longer follow-up period are required.

scholarly journals The use of Direct-Acting Antivirals in Hepatitis C Virus-Infected Patients with Hepatocellular Carcinoma

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S201-S202
Author(s):  
Minas Economides ◽  
Jeff Hosry ◽  
Georgios Angelidakis ◽  
Ahmed Kaseb ◽  
Harrys Torres
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Direct Acting Antivirals ◽  
Direct Acting
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