Recently, two conflicting articles about recurrence of hepatocellular carcinoma (HCC) after direct acting antivirals (DAA) against hepatitis C virus (HCV) were published. We investigated the relationship between DAA and HCC recurrence. Eligible patients were (1) history of HCC and treated curatively with interventions, and (2) interferon-free DAA therapy was initiated after eradication of HCC. We analyzed contributing factor for HCC recurrence. Ten out of 23 participants (43%) encountered recurrence of HCC. Age, sex, diabetes mellitus, fibrosis score, chemistry, and alpha-fetoprotein did not differ between patients with recurrence and patients without recurrence. The patients with recurrence had significantly higher values of antibody to hepatitis B core antigen (anti-HBc) than the patients without recurrence, 6.06±3.75 vs. 0.91±2.43 (p=0.0019). The relative risk of HCC recurrence comparing anti-HBc positive to negative was 5.2 (95% confidence interval 1.40 to 19.32). Odds ratio was 22.0 (95% confidence interval 2.5 to 191.1). We conclude that anti-HBc positivity was a strong contributing factor for HCC recurrence after DAA therapy.
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This study was supported, in part, by the Research Program on Hepatitis research from the Japan Agency for Medical Research and Development, AMED, and a grant for Practical Research on Hepatitis B from the Ministry of Health, Labour, and Welfare of Japan, and a grant-in-aid from the Ministry of Education, Culture, Sports, Science and Technology, Japan.
Conflict of interest
HS, KM, SI, TF, MN, KT, HT, HN, MN, and TW declare that they have no conflict of interest.
Not required, because this was a retrospective analysis of the past clinical records.
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Shimizu, H., Matsui, K., Iwabuchi, S. et al. Relationship of hepatitis B virus infection to the recurrence of hepatocellular carcinoma after direct acting antivirals. Indian J Gastroenterol 36, 235–238 (2017). https://doi.org/10.1007/s12664-017-0755-3
- Direct acting antivirals
- HBc antibody
- Hepatitis B virus
- Hepatocellular carcinoma
- Recurrence of HCC