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Hep C Discussion Forum -> Knowledge/Info Section -> HCC Incidence after DAA treatment
Post Info TOPIC: HCC Incidence after DAA treatment
Canuck


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HCC Incidence after DAA treatment
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hm, hope this graph is not too small to read - I could not seem to get it to enlarge.

One of the abstracts (number 142) that was presented at the recent 2017 Liver Meeting, contained a simlar graph to the one below - it highlights the findings of G. Ioannou's (and co-authors) work (titled below).

I had to source this from J Hepatol. 2017 Sep 5. pii: S0168-8278(17)32273-0. doi: 10.1016/j.jhep.2017.08.030. [Epub ahead of print].

I just wanted to bring these calculations to the fore, as it just re-confirms (to me) the distinct benefits of early resolution of HCV with DAA's before cirrhosis develops. 

HCV eradication induced by direct-acting antiviral agents reduces the risk of hepatocellular carcinoma.

Ioannou GN1, Green PK2, Berry K2.

 Figure thumbnail fx1

Abstract

BACKGROUND AND AIMS:

It is unclear whether direct-acting antiviral (DAA) treatment-induced sustained virologic response (SVR) reduces the risk of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV) infection. We aimed to determine the impact of DAA-induced SVR on HCC risk.

METHODS:

We identified 62,354 patients who initiated antiviral treatment in the Veterans Affairs (VA) national healthcare system from 1/1/1999 to 12/31/2015, including 35,871 (58%) interferon-only regimens, 4535 (7.2%) DAA+interferon regimens and 21,948 (35%) DAA-only regimens. We retrospectively followed patients until 6/15/2017 to identify incident cases of HCC. We used Cox proportional hazards regression to determine the association between SVR and HCC risk or between type of antiviral regimen (DAA-only vs DAA+interferon vs Interferon-only) and HCC risk.

RESULTS:

We identified 3271 incident cases of HCC diagnosed at least 180 days after initiation of antiviral treatment during a mean follow-up of 6.1 years. The incidence of HCC was highest in patients with cirrhosis and treatment failure (3.25 per 100 patient-years), followed by cirrhosis and SVR (1.97), no cirrhosis and treatment failure (0.87) and no cirrhosis and SVR (0.24). SVR was associated with a significantly decreased risk of HCC in multivariable models irrespective of whether the antiviral treatment was DAA-only (adjusted hazard ratio [AHR] 0.29, 95% CI 0.23-0.37), DAA+interferon (AHR 0.48, 95% CI 0.32-0.73) or interferon-only (AHR 0.32, 95% CI 0.28-0.37). Receipt of a DAA-only or DAA+interferon regimen was not associated with increased HCC risk compared to receipt of an interferon-only regimen.

CONCLUSIONS:

DAA-induced SVR is associated with a 71% reduction in HCC risk. Treatment with DAAs is not associated with increased HCC risk compared to treatment with interferon.

LAY SUMMARY:

Eradication of hepatitis C infection with direct-acting antiviral agents reduces the risk of liver cancer dramatically.

Published by Elsevier B.V.

 

 

 



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

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