How Do Direct-Acting Antivirals for HCV Affect HCC Risk?

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How Do Direct-Acting Antivirals for HCV Affect HCC Risk?

COMMENTARY
How Do Direct-Acting Antivirals for Hepatitis C Affect the Risk for Hepatocellular Carcinoma?
Sheila L. Eswaran, MD, MS; Nancy Reau, MD
August 15, 2017

The latest data on the controversial hepatitis C-hepatocellular carcinoma treatment link are examined.

Hepatocellular carcinoma (HCC), which has an annual incidence rate of 1%-4%,[1] is a potential complication of hepatitis C virus (HCV) cirrhosis owing to a multistep carcinogenesis pathway. Previous HCV treatment with interferon was associated with poor cure rates and was limited to individuals with early fibrosis or well-compensated cirrhosis. Such therapy, however, also led to a decrease in HCC after a sustained viral response (SVR).[2,3] Although remarkable progress has occurred in curing HCV in the current direct-acting antiviral (DAA) era, there is controversy regarding the associated risk of patients developing either incident (new, de novo) or recurrent HCC after DAA treatment. Additional data also suggest a lower SVR rate in patients with HCC.


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