Relationship of hepatitis B virus infection to the recurrence of hepatocellular carcinoma after direct acting antivirals


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.

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Correspondence to Keiji Matsui.

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HS, KM, SI, TF, MN, KT, HT, HN, MN, and TW declare that they have no conflict of interest.

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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).

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  • Direct acting antivirals
  • HBc antibody
  • Hepatitis B virus
  • Hepatocellular carcinoma
  • Recurrence
  • Recurrence of HCC