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Direct-acting antivirals do not raise HCC risk in hepatitis C patients

22 Jul 2018
Authorities in Malaysia have approved a compulsory license for Hepatitis C treatment, which allows for cheaper generic medication to be produced without the drug patent holder’s consent.

In patients with advanced hepatitis C infections, taking direct-acting antivirals (DAAs) does not increase the risk of subsequent hepatocellular carcinoma (HCC), a recent study has shown.

Researchers conducted a prospective study of 3,917 patients with hepatitis C infection who were taking DAAs (mean age 58.1±11.9 years; 62.2 percent male); only those with fibrosis stage F3 were eligible for inclusion. Cox regression analyses were performed to identify risk factors for HCC development.

Over a mean follow-up of 536.2±197.6 days, 55 new cases of HCC were reported, yielding an overall incidence rate of 0.97 percent patients per year. The corresponding incidence rate in cirrhotic patients was 1.18 percent patients per year.

Multivariate analysis of baseline variables showed that coinfection with hepatitis B virus (hazard ratio [HR], 3.99; 95 percent CI, 1.24–12.91; p=0.021) and APRI (aspartate aminotransferase-to-platelet ratio) score >2.5 (HR, 2.03; 1.14–3.61; p=0.016) were significant and independent risk factors for HCC development.

In 55 patients who developed HCC (mean age 59.15±9.7 years; 37 males), all hepatitis C virus genotypes were present. The time from DAA initiation to HCC diagnosis ranged from 4–57 weeks and averaged 31.8±20.1 weeks. Twenty-two patients developed HCC while on DAA medication.

In relation to virological outcomes, those who experienced sustained virological response (SVR) were less likely to contract the aggressive form of HCC than in those without SVR (54.6 percent vs 12.1 percent). Moreover, the aggressive HCC pattern was more common during the early periods of observation, while the less aggressive form predominated during later follow-ups.

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Most Read Articles
5 days ago
Use of statin appears to reduce the risks of osteoporosis, hip fractures and vertebral fracture in patients newly diagnosed with a stroke, suggests a recent study.
2 days ago
Elderly adults using hypoglycaemic glucose-lowering drugs, such as insulin and glinides, have an excess risk of hospitalization for serious trauma, a recent study has found.
07 Oct 2018
Patients using long-acting opioids with immunosuppressive properties are at greater risk of developing serious infections compared with those using the nonimmunosuppressive opioid counterpart, according to a study.
6 days ago
Monitoring of adverse events is lower in ambulatory patients on amiodarone than in those on dofetilide, a recent study has found. Improving the monitoring of such agents may help reduce the risk of morbidity in this population.