scholarly journals Hepatitis C: An Overview

2021 ◽  
Author(s):  
Syed Manzoor Kadri ◽  
Marija Petkovic
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Sexual Transmission ◽  
Therapeutic Modalities ◽  
Increased Risk ◽  
Promising Treatment ◽  
Health Care Performance ◽  
Direct Acting ◽  
Acid Test ◽  
Liver Infection

Hepatitis C virus (HCV) has infected approximatelly 130–170 milion individuals in the form of chronic liver infection and hepatocellular carcinoma. In the majority of patients with the increased risk for hepatocellular carcinoma the initial rearrangement is fibrosis. HCV is a bloodborne virus. The most common route of the infection are drug use, injections, unsafe health care performance, transfusion and sexual transmission. The incubation period ranges from 2 to 6 weeks in case of HCV. HCV infection is diagnosed in the process of detecting of anti-HCV antibodies and if positive, a nucleic acid test for HCV ribonucleic acid (RNA) is done. Currently, the most promising treatment agents are direct-acting antivirals (DAAs). They have shown limited viral resistance, long treatment duration and higher cost with no proven benefits in the prevention of graft reinfections in HCV individuals. In the light of the aforementioned, there is a need to a more dubious research in the quest for the effective therapeutic modalities.

scholarly journals Assessment of Liver Stiffness Regression and Hepatocellular Carcinoma Risk in Chronic Hepatitis C Patients after Treatment with Direct-Acting Antiviral Drugs

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 210
Author(s):  
Martynas Ridziauskas ◽  
Birutė Zablockienė ◽  
Ligita Jančorienė ◽  
Artūras Samuilis ◽  
Rolandas Zablockis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Liver Stiffness ◽  
Direct Acting Antiviral ◽  
End Of Treatment ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Direct Acting

Background and Objectives: Chronic hepatitis C virus infection affects about 71 million people worldwide. It is one of the most common chronic liver conditions associated with an increased risk of developing liver cirrhosis and cancer. The aim of this study was to evaluate changes in liver fibrosis and the risk of developing hepatocellular carcinoma after direct-acting antiviral drug therapy, and to assess factors, linked with these outcomes. Materials and Methods: 70 chronic hepatitis C patients were evaluated for factors linked to increased risk of de novo liver cancer and ≥ 20% decrease of ultrasound transient elastography values 12 weeks after the end of treatment. Results: The primary outcome was an improvement of liver stiffness at the end of treatment (p = 0.004), except for patients with diabetes mellitus type 2 (p = 0.49). Logistic regression analysis revealed factors associated with ≥ 20% decrease of liver stiffness values: lower degree of steatosis in liver tissue biopsy (p = 0.053); no history of interferon-based therapy (p = 0.045); elevated liver enzymes (p = 0.023–0.036); higher baseline liver stiffness value (p = 0.045) and absence of splenomegaly (p = 0.035). Hepatocellular carcinoma developed in 4 (5.7%) patients, all with high alpha-fetoprotein values (p = 0.0043) and hypoechoic liver mass (p = 0.0001), three of these patients had diabetes mellitus type 2. Conclusions: Liver stiffness decrease was significant as early as 12 weeks after the end of treatment. Patients with diabetes and advanced liver disease are at higher risk of developing non-regressive fibrosis and hepatocellular carcinoma even after successful treatment.

scholarly journals Hepatocellular Carcinoma in Hepatitis C-Associated Cirrhotic Patients Treated with Different Combinations of Direct-Acting Antiviral Agents Available in Pakistan: A Prospective Observational Study

2021 ◽  
Vol 15 (10) ◽  
pp. 3157-3160
Author(s):  
Irshad Batool Abro ◽  
Prem Kumar ◽  
Imran Arshad ◽  
Shagufta Memon ◽  
Ali Akbar Siddiqui
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Hepatitis C ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Treatment Time ◽  
University Hospital ◽  
Increased Risk ◽  
Pugh Class ◽  
Direct Acting

Background: The hepatitis C virus (HCV) is a leading cause of chronic liver disease, including hepatic cirrhosis and hepatocellular cancer (HCC). Drugs that act directly on the virus, like as direct-acting antivirals (DAAs), are associated with improved long-term virologic responses and reduced treatment time. Pakistani patients with HCV-related cirrhosis receiving DAA medication were studied to see if they had an increased risk of hepatocellular carcinoma (HCC). Material and Methods: We conducted a prospective observational study at Isra University Hospital Hyderabad from July 2019 to August 2020. Three hundred fourteen patients met the inclusion criteria and were included. We recorded baseline demographic characteristics, Child-Pugh class, model for end-stage liver disease (MELD) score, alpha-fetoprotein level, and abdominal ultrasound/computed tomography (CT) scan before and after treatment. Results: Three hundred-fourteen individuals took part in the research. The average age of participant with hepatocellular carcinoma was 46.7 years. Twenty (sixty-nine) of the participants developing hepatocellular carcinoma were men, while nine (thirty-one percent) were women (p=0.221). Five (17.2%) of the HCC participants were diabetics, and seventeen (58.6%) were tobacco users (p=0.001). Twenty individuals (69%) developed HCC after receiving a combination of sofosbuvir and daclatasvir. A sofosbuvir/velpatasvir combination led to the development of HCC in nine (31%) of individuals (p=0.1). HCC was diagnosed in eight individuals under the age of forty (27.6%), but in 21 patients beyond the age of forty (72.6%) (p=0.55). HCC was found in 65.6 percent of Child-Turcotte-Pugh class A participants. Conclusion: DAAs have been linked to a higher risk of HCC. Participants receiving a combo of sofosbuvir/daclatasvir were more likely to develop HCC than those who received sofosbuvir/velpatasvir alone. Keywords: Velpatasvir, Hepatocellular carcinoma, Sofosbuvir, Cirrhosis,

Use of direct-acting antivirals for hepatitis C viral infection and association with intrahepatic cholangiocarcinoma: Is there a linkage?

2018 ◽  
Vol 25 (7) ◽  
pp. 1743-1748 ◽  
Author(s):  
Anusha Vakiti ◽  
Min Ho Cho ◽  
Wen Lee ◽  
John J Liang ◽  
Alexander T Lalos ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Viral Infection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Sustained Virologic Response ◽  
Virologic Response ◽  
Direct Acting Antivirals ◽  
Nonstructural Proteins ◽  
Increased Risk ◽  
Direct Acting

Hepatitis C viral infection is recognized worldwide as a leading cause of cirrhosis and hepatocellular carcinoma. The goal of hepatitis C viral antiviral therapy is the permanent eradication of hepatitis C viral RNA, commonly referred to as a sustained virologic response – defined as “undetectable” RNA at 12 weeks following the completion of therapy. Hepatitis C viral treatment has dramatically advanced with the FDA approval of several new agents known as direct-acting antivirals. These drugs target specific nonstructural proteins of the virus, which disrupt viral replication, and therefore halt infection. However, recently, there has been a concern for increased risk of recurrence of treated hepatocellular carcinoma or denovo occurrence of hepatocellular carcinoma after treatment with direct-acting antivirals. We are now reporting three cases of intrahepatic cholangiocarcinoma that developed after sustained virologic response following hepatitis C viral treatment with direct-acting antivirals.

Hepatocellular Carcinoma Occurrence and Recurrence after Antiviral Treatment in HCV-Related Cirrhosis. Are Outcomes Different after Direct Antiviral Agents? A Review

2017 ◽  
Vol 26 (4) ◽  
pp. 403-410 ◽  
Author(s):  
Zeno Spârchez ◽  
Tudor Mocan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Antiviral Treatment ◽  
Antiviral Agents ◽  
Antiviral Agent ◽  
Virologic Response ◽  
Viral Clearance ◽  
Increased Risk ◽  
Direct Acting

Hepatitis C virus (HCV) infection is one of the major causes of hepatocellular carcinoma (HCC) worldwide. In the last decades, several studies have showed a lower rate of HCC occurrence or recurrence in patients with HCV-related cirrhosis after interferon-based antiviral therapies compared to untreated controls, even without reaching viral clearance. Unfortunately, interferon regimens could only yield viral clearance in approximately half of the patients. The recent development of new all-oral regimens with direct-acting antivirals (DAAs) has radically improved the cure rate to above 90%. In respect to these findings, many would have thought that interferon-free regimens would decrease the development and recurrence of HCC. Literature data have unexpectedly reported high rates of both the occurrence and recurrence of HCC after therapy with DAAs. However, it is probably too early to express some concerns. More recent data showed that both occurrence and recurrence of HCC are decreased by the DAAs. Interferon-free therapy is definitely not without limits. Together with the initial thoughts of an increased risk of HCC, these may lead to an unwanted restricted access to interferon-free regimens in specific subpopulations. This issue should be settled as soon as possible because millions of hepatitis C patients are and will be using DAAs in the present and future. Our purpose is to review the existing literature and to offer a more precise and rational interpretation of the existing data.Key words:  –  – e – .Abreviations: AFP: alpha-fetoprotein; DAA: direct antiviral agent; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; HR: hazard ratio; IFN: interferon; LDV: Ledispavir; SMV: Simeprevir; SOF: Sofosbuvir; SVR: sustained virologic response.

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