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The Impact of Direct-acting Antiviral Therapy for Hepatitis C on Hepatocellular Carcinoma Risk

Current Hepatology Reports volume 17, pages 377–384 (2018)Cite this article

Abstract

Purpose of Review

Direct-acting antiviral agents (DAAs) eradicate hepatitis C virus (HCV) infection in the majority of patients. We critically evaluated the impact of DAAs on hepatocellular carcinoma (HCC) risk, a major complication of HCV infection.

Recent Findings

Large cohort studies show that patients who achieve sustained virologic response (SVR) with DAAs have a significantly lower risk of developing de novo HCC than patients who fail treatment or remain untreated. Furthermore, reduction in HCC risk is similar whether SVR is achieved with DAAs or interferon (IFN). However, DAA-induced SVR does not eliminate HCC risk entirely. Therefore, patients with pre-existing cirrhosis require ongoing surveillance even after SVR is achieved.

Early, descriptive, uncontrolled reports suggested that DAAs may increase the risk of recurrent HCC. While studying HCC recurrence presents major methodologic challenges, larger studies containing appropriate comparison control groups largely refuted these concerns.

Summary

Recent studies provide evidence that DAA-induced SVR reduces HCC risk.

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Fig. 1

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Affiliations

  1. Division of Gastroenterology, University of Washington, Seattle, WA, USA

    Feng Su & George N. Ioannou

  2. Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System, S-111-Gastro, 1660 S. Columbian Way, Seattle, WA, 98108, USA

    Feng Su & George N. Ioannou

  3. Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA

    George N. Ioannou

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Correspondence to George N. Ioannou.

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Feng Su and George N. Ioannou each declare no potential conflict of interest.

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This article is part of the Topical Collection on Hepatic Cancer

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Su, F., Ioannou, G.N. The Impact of Direct-acting Antiviral Therapy for Hepatitis C on Hepatocellular Carcinoma Risk. Curr Hepatology Rep 17, 377–384 (2018). https://doi.org/10.1007/s11901-018-0424-8

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  • DOI: https://doi.org/10.1007/s11901-018-0424-8

Keywords

  • Direct-acting antiviral
  • Hepatitis C
  • Hepatocellular carcinoma
  • Sustained virologic response