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Hepatitis C and Hepatocellular Carcinoma

  • Hepatitis C (J Ahn, Section Editor)
  • Published:
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Abstract

With the significant burden of hepatocellular carcinoma (HCC) attributable to hepatitis C (HCV), prevention of HCC should first and foremost include treatment of hepatitis C. At the very least, any patient who is at risk for liver disease progression to advanced fibrosis should have HCV treated. This is potentially one of the single most important interventions that can be employed long-term to decrease the incidence of HCV-related HCC. Furthermore, efforts should be made in proactively treating HCV in patients listed for liver transplant with HCC and those HCC patients with limited tumor burden treated with curative intent. Studies exploring more specifically which patients with HCC receiving liver-directed therapy should also have HCV treated need to be performed. The overall cost effectiveness of treating those with significant HCC tumor burden needs to be better understood. With new direct acting antivirals for the treatment of HCV, it is becoming increasingly difficult to find reasons to leave virtually any patient with hepatitis C untreated who is at risk for HCC or with HCC. Although there are limited data directly linking the treatment of HCV with the incidence of HCC, this is a tremendous opportunity to change the epidemiology of HCC by utilizing treatment for hepatitis C.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. El-Serag HB, Mason AC. Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med. 1999;340(10):745–50.

    Article  CAS  PubMed  Google Scholar 

  2. Ryerson AB, et al. Annual Report to the Nation on the Status of Cancer, 1975-2012, featuring the increasing incidence of liver cancer. Cancer. 2016. doi:10.1002/cncr.29936. Paper highlights the increasing incidence of liver cancer and the ongoing burden of disease in the US.

  3. Caldwell S, Park SH. The epidemiology of hepatocellular cancer: from the perspectives of public health problem to tumor biology. J Gastroenterol. 2009;44 Suppl 19:96–101.

    Article  PubMed  Google Scholar 

  4. Sangiovanni A et al. The natural history of compensated cirrhosis due to hepatitis C virus: a 17-year cohort study of 214 patients. Hepatology. 2006;43(6):1303–10.

    Article  PubMed  Google Scholar 

  5. Fattovich G et al. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004;127(5 Suppl 1):S35–50.

    Article  PubMed  Google Scholar 

  6. Groom H et al. Outcomes of a hepatitis C screening program at a large urban VA medical center. J Clin Gastroenterol. 2008;42(1):97–106.

    Article  PubMed  Google Scholar 

  7. Vizuete J, Hubbard H, Lawitz E. Next-generation regimens: the future of hepatitis C virus therapy. Clin Liver Dis. 2015;19(4):707–16. vii.

    Article  PubMed  Google Scholar 

  8. Younossi ZM et al. Disparate access to treatment regimens in chronic hepatitis C patients: data from the TRIO network. J Viral Hepat. 2016. doi:10.1111/jvh.12506.

  9. Lo Re V 3rd et al. Disparities in absolute denial of modern hepatitis C therapy by type of insurance. Clin Gastroenterol Hepatol. 2016. doi:10.1016/j.cgh.2016.03.040.

  10. Lok AS et al. Incidence of hepatocellular carcinoma and associated risk factors in hepatitis C-related advanced liver disease. Gastroenterology. 2009;136(1):138–48.

    Article  CAS  PubMed  Google Scholar 

  11. El-Serag HB, et al. Risk of Hepatocellular Carcinoma after Sustained Virologic Response in Veterans with HCV-infection. Hepatology. 2016. doi:10.1002/hep.28535. Reference underscores that HCC risk remains after eradication of HCV, although the risk of HCC is significantly less after eradication that in patients who do not.

  12. Tokita H et al. Risk factors for the development of hepatocellular carcinoma among patients with chronic hepatitis C who achieved a sustained virological response to interferon therapy. J Gastroenterol Hepatol. 2005;20(5):752–8.

    Article  CAS  PubMed  Google Scholar 

  13. Singal AG et al. A sustained viral response is associated with reduced liver-related morbidity and mortality in patients with hepatitis C virus. Clin Gastroenterol Hepatol. 2010;8(3):280–8. 288 e1.

    Article  PubMed  Google Scholar 

  14. Denniston MM et al. Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010. Ann Intern Med. 2014;160(5):293–300.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Volk ML et al. Public health impact of antiviral therapy for hepatitis C in the United States. Hepatology. 2009;50(6):1750–5.

    Article  PubMed  Google Scholar 

  16. AASLD-IDSA. Recommendations for testing, managing, and treating hepatitis C. 2016. http://www.hcvguidelines.org.

  17. Reig M. et al. Unexpected early tumor recurrence in patients with hepatitis C virus -related hepatocellular carcinoma undergoing interferon-free therapy: a note of caution. J Hepatol. 2016. doi:10.1016/j.jhep.2016.04.008. Paper demonstrated increased early recurrence of HCC after treatment of HCV with DAA therapy. Future studies regarding this question are greatly needed.

  18. Morgan TR et al. Outcome of sustained virological responders with histologically advanced chronic hepatitis C. Hepatology. 2010;52(3):833–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Chen T, Terrault N. Treatment of chronic hepatitis C in patients with cirrhosis. Curr Opin Gastroenterol. 2016;32(3):143–51.

    PubMed  Google Scholar 

  20. Younossi ZM et al. Effects of sofosbuvir-based treatment, with and without interferon, on outcome and productivity of patients with chronic hepatitis C. Clin Gastroenterol Hepatol. 2014;12(8):1349–59.e13.

    Article  CAS  PubMed  Google Scholar 

  21. Neary MP et al. Sustained virologic response is associated with improved health-related quality of life in relapsed chronic hepatitis C patients. Semin Liver Dis. 1999;19 Suppl 1:77–85.

    PubMed  Google Scholar 

  22. Boscarino JA et al. Predictors of poor mental and physical health status among patients with chronic hepatitis C infection: the Chronic Hepatitis Cohort Study (CHeCS). Hepatology. 2015;61(3):802–11.

    Article  PubMed  Google Scholar 

  23. Charlton M et al. Ledipasvir and sofosbuvir plus ribavirin for treatment of HCV infection in patients with advanced liver disease. Gastroenterology. 2015;149(3):649–59.

    Article  CAS  PubMed  Google Scholar 

  24. Curry MP et al. Sofosbuvir and velpatasvir for HCV in patients with decompensated cirrhosis. N Engl J Med. 2015;373(27):2618–28.

    Article  CAS  PubMed  Google Scholar 

  25. Holmes HM et al. Reconsidering medication appropriateness for patients late in life. Arch Intern Med. 2006;166(6):605–9.

    Article  PubMed  Google Scholar 

  26. Maddison AR, Fisher J, Johnston G. Preventive medication use among persons with limited life expectancy. Prog Palliat Care. 2011;19(1):15–21.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Welzel TM et al. Population-attributable fractions of risk factors for hepatocellular carcinoma in the United States. Am J Gastroenterol. 2013;108(8):1314–21. Paper underscores the changing epidemiology of HCC over time.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Schlansky B et al. Waiting time predicts survival after liver transplantation for hepatocellular carcinoma: a cohort study using the United Network for Organ Sharing registry. Liver Transpl. 2014;20(9):1045–56.

    Article  PubMed  Google Scholar 

  29. Kim GA et al. Radiofrequency ablation as an alternative to hepatic resection for single small hepatocellular carcinomas. Br J Surg. 2016;103(1):126–35.

    Article  CAS  PubMed  Google Scholar 

  30. N’Kontchou G et al. Radiofrequency ablation of hepatocellular carcinoma: long-term results and prognostic factors in 235 Western patients with cirrhosis. Hepatology. 2009;50(5):1475–83.

    Article  CAS  PubMed  Google Scholar 

  31. Santambrogio R et al. Surgical resection versus laparoscopic radiofrequency ablation in patients with hepatocellular carcinoma and Child-Pugh class a liver cirrhosis. Ann Surg Oncol. 2009;16(12):3289–98.

    Article  PubMed  Google Scholar 

  32. Liu H et al. Randomized clinical trial of chemoembolization plus radiofrequency ablation versus partial hepatectomy for hepatocellular carcinoma within the Milan criteria. Br J Surg. 2016;103(4):348–56.

    Article  CAS  PubMed  Google Scholar 

  33. Takayasu K et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology. 2006;131(2):461–9.

    Article  CAS  PubMed  Google Scholar 

  34. Llovet JM et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–90.

    Article  CAS  PubMed  Google Scholar 

  35. Toyoda H et al. Comparison of the usefulness of three staging systems for hepatocellular carcinoma (CLIP, BCLC, and JIS) in Japan. Am J Gastroenterol. 2005;100(8):1764–71.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L-461, Portland, OR, 97239, USA

    Janice Jou & Willscott E. Naugler

  2. Portland VA Medical Center, Portland, OR, USA

    Janice Jou

Authors
  1. Janice Jou
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  2. Willscott E. Naugler
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Correspondence to Willscott E. Naugler.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hepatitis C

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Jou, J., Naugler, W.E. Hepatitis C and Hepatocellular Carcinoma. Curr Hepatology Rep 15, 291–295 (2016). https://doi.org/10.1007/s11901-016-0312-z

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  • DOI: https://doi.org/10.1007/s11901-016-0312-z

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