Direct-acting antivirals do not accelerate recurrence of hepatitis C-related HCC
Using direct-acting antivirals (DAA) in treating chronic hepatitis C does not seem to accelerate the recurrence of hepatitis C-related hepatocellular carcinoma (HCC) after curative therapy, a new study has shown.
The study included 147 patients (median age 74.4 years; 59 percent male) successfully treated with radiofrequency ablation for hepatitis C- related HCC and who received antiviral treatment with DAAs. A comparison group of 156 patients (median age 65.3 years; 75 percent male) treated with interferon (IFN)-based therapy was also included.
Over a median observation period of 1.8 years, 80 patients in the DAA group developed HCC recurrence. The resulting 1- and 2-year tumour recurrence rates were 39 percent and 60 percent, respectively. In comparison, 136 recurrence events were recorded over 7.2 observation years in the IFN group, resulting in 1- and 2-year recurrence rates of 39 percent and 61 percent, respectively (p=0.43).
Recurrence patterns did not significantly differ between the DAA and IFN groups (chi-squared test p=0.70). For instance, intrahepatic recurrence of up to three tumours <3 cm in diameter occurred in 85 percent and 84 percent of the IFN- and DAA-treated patients, respectively.
Moreover, extrahepatic metastases were recorded in one patient who received IFN treatment and in two who were given DAAs.
Multivariate Cox proportional hazard regression analysis identified a larger number of HCC treatments and a shorter time between the last HCC treatment and initiation of antiviral therapy as independent risk factors for HCC recurrence.