TY - JOUR
T1 - Occurrence of hepatocellular carcinoma after direct-acting antiviral therapy for hepatitis C virus infection
T2 - literature review and risk analysis
AU - Galati, Giovanni
AU - Muley, Moises
AU - Viganò, Mauro
AU - Iavarone, Massimo
AU - Vitale, Alessandro
AU - Dell’Unto, Chiara
AU - Lai, Quirino
AU - Cabibbo, Giuseppe
AU - Sacco, Rodolfo
AU - Villa, Erica
AU - Trevisani, Franco
PY - 2019/7/3
Y1 - 2019/7/3
N2 - 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.
AB - 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.
KW - DAA/direct-acting antivirals
KW - HCC
KW - HCV
KW - Hepatocellular carcinoma
KW - occurrence
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U2 - 10.1080/14740338.2019.1617272
DO - 10.1080/14740338.2019.1617272
M3 - Review article
C2 - 31067134
AN - SCOPUS:85067605582
VL - 18
SP - 603
EP - 610
JO - Expert Opinion on Drug Safety
JF - Expert Opinion on Drug Safety
SN - 1474-0338
IS - 7
ER -