Titre : Minireview - DAAs and the occurrence or recurrence of HCC among patients with HCV related liver disease
link : Minireview - DAAs and the occurrence or recurrence of HCC among patients with HCV related liver disease
Minireview - DAAs and the occurrence or recurrence of HCC among patients with HCV related liver disease
MinireviewsWorld J Hepatol. Feb 27, 2018; 10(2): 267-276
Published online Feb 27, 2018.
doi: 10.4254/wjh.v10.i2.267
Impact of direct acting antivirals on occurrence and recurrence of hepatocellular carcinoma: Biologically plausible or an epiphenomenon?
Amna Subhan Butt, Fatima Sharif, Shahab Abid
The ground breaking discovery of the new group of direct acting antiviral agents (DAAs) had led to a paradigm shift in the management of chronic hepatitis C (CHC) which is the most common cause of hepatocellular carcinoma (HCC) in Japan, Pakistan, United States and many European countries[1,2]. With annual incidence of HCC ranging from 1% to 7% in patients with HCV related cirrhosis, (HCC) is a leading cause of morbidity and the second most common cause of cancer related deaths worldwide[3,4]. Besides contribution of several host and viral factors in the pathogenesis of disease progression, achieving sustained virologic response (SVR) has been found as the single most important factor in reducing HCV associated HCC incidence[5].
The novel DAAs not only provided a potent, oral alternative to injectable interferons, but also had a shorter duration of treatment, better efficacy with over 90% achievement of SVR and a more favorable side effect profile[6]. However, since 2016, concerns were raised regarding the effect of DAAs on progression to HCC[7]. In addition, their long-term benefits including impact on HCC have been questioned in the context of specific populations and subgroups which were not included in the landmark trials investigating DAA based therapy[3].
Therefore, this review aims to explore existing molecular studies as well as clinical observations in order to determine whether there is an association between the use of DAAs and the occurrence or recurrence of HCC among patients with HCV related liver disease. We also aim to evaluate whether there is a subset of the population in which this phenomenon has been observed.
Full text review: https://www.wjgnet.com/1948-5182/full/v10/i2/267.htm
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