Occurrence of hepatocellular carcinoma after direct-acting antiviral therapy for hepatitis C virus infection: literature review and risk analysis

Giovanni Galati, Moises Muley, Mauro Viganò, Massimo Iavarone, Alessandro Vitale, Chiara Dell’Unto, Quirino Lai, Giuseppe Cabibbo, Rodolfo Sacco, Erica Villa, Franco Trevisani

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Concerns were raised about a high occurrence of hepatocellular carcinoma (HCC) after successful treatment of chronic hepatitis C (CHC) by direct-acting antivirals (DAAs). Areas covered: The authors summarize the clinical studies reporting the occurrence rate and risk factors of HCC after DAAs in CHC. Expert opinion: The recent introduction of all-oral DAAs has substantially changed the scenario of CHC, achieving a sustained virological response (SVR) in >90% of cases. Earlier concerns raised about an increasing incidence of HCC post-DAAs were flawed by large heterogeneity of patients, the limited number of well-designed prospective studies (only nine, up to date) and the inclusion of a large number of patients with advanced liver disease, previously excluded from interferon-based studies. Current data on DAAs have shown a lower risk of HCC development; however, they were unable to identify patients at greater risk for HCC occurrence after SVR. Surveillance strategy, likely lifelong, is mandatory in these patients according to general expert opinion.

Original languageEnglish
Pages (from-to)603-610
Number of pages8
JournalExpert Opinion on Drug Safety
Volume18
Issue number7
DOIs
Publication statusPublished - Jul 3 2019

Keywords

  • DAA/direct-acting antivirals
  • HCC
  • HCV
  • Hepatocellular carcinoma
  • occurrence

ASJC Scopus subject areas

  • Pharmacology (medical)

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