The influence of direct-acting antivirals in hepatitis C virus related hepatocellular carcinoma after curative treatment

  • Yuan-Hung Kuo
  • Jing-Houng Wang
  • Kuo-Chin Chang
  • Chao-Hung Hung
  • Sheng-Nan Lu
  • Tsung-Hui Hu
  • Yi-Hao Yen
  • Kwong-Ming Kee
  • Chien-Hung ChenEmail author


This study was done to elucidate the influence of direct-acting antiviral (DAA) agents on the recurrence of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related HCC (HCV-HCC) after curative therapies. HCV-HCC patients who received curative therapies and obtained a complete response were analyzed. From January 2017 to September 2017, 112 HCV-HCC patients received DAA and obtained a sustained virological response (SVR). From January 2006 to December 2014, another 345 HCV-HCC patients received peg-interferon-based treatment and 118 obtained SVR. From January 2012 to December 2016, 248 HCV-HCC patients had complete HCC response and did not receive antiviral treatment. Patients were divided into DAA, IFN, and Untreated groups based on what antiviral treatment they received. There were 82 patients in the DAA group, 80 patients in the IFN group, and 160 patients in the Untreated group. During the follow-up period, the DAA group had 22 (26.8%) recurrent cases, whereas the IFN group had 46 (56.8%) cases after antiviral treatment. Among the 22 recurrent cases in the DAA group, 19 (86.9%) experienced HCC recurrence during 1 year after DAA initiation. Compared with the IFN group, the DAA group had poorer one-year recurrence-free survival (75.4% vs. 95%, p < 0.001), even after adjustment with propensity score matching (81.4% vs. 93.9%, p = 0.034). However, DAA was an improving factor for HCC recurrence compared with the Untreated group in the multivariate analysis. Among HCV-HCC patients with complete treatment, those with DAA-induced SVR had a higher one-year recurrence rate than those who received IFN-based antiviral therapy, but DAA did not seem to increase HCC recurrence compared to untreated patients.


Direct-acting antiviral agent Hepatocellular carcinoma Hepatitis C virus Interferon-based therapy Recurrence 



We thank Miss Nien-Tzu Hsu and the biostatistics center of Kaohsiung Chang Gung Memorial Hospital for excellent statistics works.


This study was supported by a grant from Chang Gung Memorial Hospital (CMRPG:8F0443).

Compliance with ethical standards

Conflict of interest

Yuan-Hung Kuo declares that he has no conflict of interest. Jing-Houng Wang declares that he has no conflict of interest. Kuo-Chin Chang declares that he has no conflict of interest. Chao-Hung Hung declares that he has no conflict of interest. Sheng-Nan Lu declares that he has no conflict of interest. Tsung-Hui Hu declares that he has no conflict of interest. Yi-Hao Yen declares that he has no conflict of interest. Kwong-Ming Kee declares that he has no conflict of interest. Chien-Hung Chen declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. And this study was also approved by the Institutional Review Board of our institute: Kaohsiung Chang Gung Memorial Hospital.

Informed consent

For this type of retrospective study, informed consent is not required.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Hepatogastroenterology, Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung CityTaiwan
  2. 2.Division of Hepatogastroenterology, Department of Internal MedicineChiayi Chang Gung Memorial HospitalChiayiTaiwan

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