Patterns of Hepatocellular Carcinoma After Direct Antiviral Agents and Pegylated-Interferon Therapy

AbstractWe prospectively investigated the changes of liver stiffness (LS) and the occurrence of hepatocellular carcinoma (HCC) after hepatitis C virus (HCV) eradication using direct antiviral agents (DAA) over three years. LS measurement using transient elastography and serum fibrosis surrogate markers before treatment and at 48, 96, 144 weeks after starting direct-acting antivirals (DAA) according to the protocol were evaluated. Patients were also compared with historical cohort treated with pegylated interferon (peg-IFN). Sustained viral response (SVR) was observed in 95.8%. LS value in the patients achieving SVR significantly decreased over time (19.4 ± 12.9 kPa [baseline], 13.9 ± 9.1 kPa [48 weeks], 11.7 ± 8.2 kPa [96 weeks], 10.09 ± 6.23 [144 weeks], all p < 0.001). With matched analysis, the decrease in LS value was significantly larger in DAA group than peg-IFN group at both 48 weeks (29% vs. 9%) and 96 weeks (39% vs. 17%). The incidence of HCC was not significantly different between DAA and peg-IFN groups (5.5% vs. 5.4%) at 144 weeks. HCV eradication with DAA can lead to improvement of liver stiffness over time. The regression of fibrosis was greater in the group with DAA than peg-IFN.Clinical trials registration: ClinicalTrials.gov (NCT02865369).

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Adjuvant pegylated interferon therapy improves the survival outcomes in patients with hepatitis-related hepatocellular carcinoma after curative treatment

Medicine ◽

10.1097/md.0000000000011295 ◽

2018 ◽

Vol 97 (28) ◽

pp. e11295 ◽

Cited By ~ 4

Author(s):

Jiansong Wu ◽

Zhiwei Yin ◽

Liuxia Cao ◽

Xiaodan Xu ◽

Tao Yan ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Interferon Therapy ◽

Pegylated Interferon ◽

Curative Treatment ◽

Survival Outcomes

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De novo hepatocellular carcinoma in patients with cirrhosis due hepatitis C virus infection after treatment with direct antiviral agents

Journal of Hepatology ◽

10.1016/s0168-8278(18)31315-1 ◽

2018 ◽

Vol 68 ◽

pp. S531-S532

Author(s):

P. Ruiz ◽

L. Deiss ◽

L. Buendía ◽

I. Erdozain ◽

C. Álvarez ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Virus Infection ◽

De Novo ◽

Antiviral Agents ◽

Hepatitis C Virus Infection ◽

Direct Antiviral Agents ◽

De Novo Hepatocellular Carcinoma

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Changing Patterns of Hepatocellular Carcinoma after Treatment with Direct Antiviral Agents

Gastrointestinal Tumors ◽

10.1159/000505326 ◽

2020 ◽

Vol 7 (1-2) ◽

pp. 50-60

Author(s):

Mohammed El Fayoumie ◽

Mahmoud Abdelhady ◽

Ahmed Gawish ◽

Usama Hantour ◽

Ismail Abdelkhaleek ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Antiviral Agents ◽

Changing Patterns ◽

Direct Antiviral Agents

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Serum miRNA Are Promising Biomarkers for the Detection of Early Hepatocellular Carcinoma after Treatment with Direct-Acting Antivirals

Cancers ◽

10.3390/cancers11111773 ◽

2019 ◽

Vol 11 (11) ◽

pp. 1773 ◽

Cited By ~ 3

Author(s):

Devis Pascut ◽

Luisa Cavalletto ◽

Muhammad Yogi Pratama ◽

Silvia Bresolin ◽

Luca Trentin ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Random Effect ◽

Antiviral Agents ◽

Least Square ◽

Occurrence Rate ◽

Patients At Risk ◽

Early Hcc ◽

Direct Antiviral Agents ◽

Direct Acting ◽

Control Study

Direct antiviral agents (DAAs) have excellent efficacy against chronic hepatitis C virus (HCV) infection. Despite this strength, recent studies raised concerns about an unexpected hepatocellular carcinoma (HCC) occurrence rate after DAA therapy. In this exploratory case-control study, we evaluated the potential use of miRNAs as serum biomarkers for the detection of early HCC in DAA-treated patients. In the discovery phase, the circulating miRNome was assessed in 10 matched patients with (HCC+) or without HCC (HCC−) occurrence. Microarray analysis was performed before (T0) and after one month of the DAA therapy (T1). MiRNAs discriminating HCC+ and HCC− patients were validated in 60 samples by means of RT-qPCR. We estimated the time-averaged difference of a given miRNA between HCC+ and HCC− patients using a bootstrapped random-effect generalized least square regression model (RE-GLS). At T0, miR-1207-5p, miR-1275, miR-3197, miR-4443, miR-3178, miR-483-5p, miR-4706, miR-4793-3p and miR-1246 discriminated HCC+ from HCC− patients (p < 0.05). At T1, only miR-1180-3p, miR-1228-3p, miR-4329 and miR-4484 (p < 0.05) discriminated HCC+ from HCC− patients. The subsequent validation phase identified miR-3197 as changing with both disease and time. Our results suggest that patients might be already committed to HCC occurrence before DAA therapy. MiR-3197 shows some potential for the identification of patients at risk of HCC during DAA treatments.

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Sustained virologic response by direct antiviral agents reduces the incidence of hepatocellular carcinoma in patients with HCV infection

Journal of Medical Virology ◽

10.1002/jmv.24663 ◽

2016 ◽

Vol 89 (3) ◽

pp. 476-483 ◽

Cited By ~ 67

Author(s):

Masahiro Kobayashi ◽

Fumitaka Suzuki ◽

Shunichiro Fujiyama ◽

Yusuke Kawamura ◽

Hitomi Sezaki ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Sustained Virologic Response ◽

Antiviral Agents ◽

Virologic Response ◽

Hcv Infection ◽

Direct Antiviral Agents

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Liver Stiffness Measurement Is Useful to Predict Early Recurrence of Hepatocellular Carcinoma after Sustained Virological Responses by Direct Antiviral Agents in Patients with Hepatitis C

Open Journal of Gastroenterology ◽

10.4236/ojgas.2018.87028 ◽

2018 ◽

Vol 08 (07) ◽

pp. 255-268

Author(s):

Noboru Hirashima ◽

Hiroaki Iwase ◽

Masaaki Shimada ◽

Noboru Urata ◽

Etsuko Iio ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis C ◽

Antiviral Agents ◽

Liver Stiffness ◽

Early Recurrence ◽

Liver Stiffness Measurement ◽

Stiffness Measurement ◽

Direct Antiviral Agents

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Clinical Outcomes After Treatment With Direct Antiviral Agents: Beyond The Virological Response in Patients With Previous HCV-Related Decompensated Cirrhosis

10.21203/rs.3.rs-724060/v1 ◽

2021 ◽

Author(s):

Georges-Philippe PAGEAUX ◽

Clovis LUSIVIKA NZINGA ◽

Nathalie GANNE ◽

Didier SAMUEL ◽

Céline DORIVAL ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Virological Response ◽

Antiviral Agents ◽

Multivariable Analysis ◽

Decompensated Cirrhosis ◽

All Cause Mortality ◽

Clinical Benefits ◽

Direct Antiviral Agents ◽

Related Mortality

Abstract Background In HCV-infected patients with advanced liver disease, the direct antiviral agents (DAAS)-associated clinical benefits remain debated. We compared the clinical outcome of patients with a previous history of decompensated cirrhosis following treatment or not with DAAs from the French ANRS CO22 HEPATHER cohort. Methods We identified HCV patients who had experienced an episode of decompensated cirrhosis. Study outcomes were all-cause mortality, liver-related or non-liver-related deaths, hepatocellular carcinoma, liver transplantation. Secondary study outcomes were sustained virological response (SVR) and its clinical benefits Results 559 patients met the identification criteria, of which 483 received DAA and 76 remained untreated after inclusion in the cohort. The median follow-up time was 39·7 (IQR: 22·7–51) months. After adjustment for multivariate analysis, exposure to DAAs was associated with a decrease in all-cause mortality (HR 0·45, 95% CI 0·24–0·84, p = 0·01) and non-liver-related death (HR 0·26, 95% CI 0·08–0·82, p = 0·02), and was not associated with liver-related death, decrease in hepatocellular carcinoma and need for liver transplantation. The SVR was 88%. According to adjusted multivariable analysis, SVR achievement was associated with a decrease in all-cause mortality (HR 0·29, 95% CI 0·15–0·54, p < 0·0001), liver-related mortality (HR 0·40, 95% CI 0·17–0·96, p = 0·04), non-liver-related mortality (HR 0·17, 95% CI 0·06–0·49, p = 0.001), liver transplantation (HR 0·17, 95% CI 0·05–0·54, p = 0.003), and hepatocellular carcinoma (HR 0·52, 95% CI 0·29–0·93, p = 0·03). Conclusion Treatment with DAAS is associated with reduced risk for mortality. Thus, DAA treatment should be considered for any patient with HCV-related decompensated cirrhosis.

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