The risks of hepatocellular carcinoma development after HCV eradication are similar between patients treated with peg-interferon plus ribavirin and direct-acting antiviral therapy

• Published in: PloS one 2017-08, Vol.12 (8), p.e0182710-e0182710
• Main Authors: Nagaoki, Yuko, Imamura, Michio, Aikata, Hiroshi, Daijo, Kana, Teraoka, Yuji, Honda, Fumi, Nakamura, Yuki, Hatooka, Masahiro, Morio, Reona, Morio, Kei, Kan, Hiromi, Fujino, Hatsue, Kobayashi, Tomoki, Masaki, Keiichi, Ono, Atsushi, Nakahara, Takashi, Kawaoka, Tomokazu, Tsuge, Masataka, Hiramatsu, Akira, Kawakami, Yoshiiku, Hayes, C Nelson, Miki, Daiki, Ochi, Hidenori, Chayama, Kazuaki
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Alcohol use; Antiviral agents; Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Antiviral drugs; Biology and life sciences; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - prevention & control; Carcinoma, Hepatocellular - virology; Care and treatment; Causes of; Comparative analysis; Complications and side effects; Control; Dosage and administration; Drug Therapy, Combination; Eradication; Gastroenterology; Genomes; Health aspects; Hepatitis; Hepatitis C; Hepatitis C virus; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; Hepatocellular carcinoma; Hepatology; Humans; Imidazoles - pharmacology; Imidazoles - therapeutic use; Incidence; Infections; Interferon; Interferon-alpha - pharmacology; Interferon-alpha - therapeutic use; Isoquinolines - pharmacology; Isoquinolines - therapeutic use; Kaplan-Meier Estimate; Laboratories; Life sciences; Liver cancer; Liver Neoplasms - epidemiology; Liver Neoplasms - prevention & control; Liver Neoplasms - virology; Medicine and Health Sciences; Metabolism; Middle Aged; Patients; Polyethylene glycol; Proportional Hazards Models; R&D; Research & development; Ribavirin; Ribavirin - pharmacology; Ribavirin - therapeutic use; Risk; Risk Factors; Sulfonamides - pharmacology; Sulfonamides - therapeutic use; Therapy; Treatment Outcome; Viral Load; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0182710

The risk of hepatocellular carcinoma (HCC) development is reduced following viral elimination by interferon therapy in chronic hepatitis C patients. However, the risk in patients treated with interferon-free direct-acting antivirals (DAAs) is unknown. We evaluated chronic hepatitis C patients who achieved viral eradication by pegylated-interferon plus ribavirin (PEG-IFN/RBV, n = 244) or daclatasvir plus asunaprevir (DCV/ASV, n = 154) therapy. None of the patients had prior history of HCC or antiviral therapy. The median observation period after the end of treatment for the PEG-IFN/RBV and DCV/ASV groups were 96 (range 10-196) and 23 (range 4-78) months, respectively. During the observation period, HCC developed in 13 (5.3%) and 7 (4.5%) patients in the PEG-IFN/RBV and DCV/ASV groups, respectively. The cumulative HCC development rate after 1-, 3- and 5-years (0.4%, 3% and 5% for the PEG-IFN/RBV group and 0.6%, 9% and 9% for the DAA group, respectively) were similar between the two groups. Propensity score matching analysis also showed no significant difference in HCC development rates between the two groups. Serum AFP levels decreased to similar levels between PEG-IFN/RBV and DCV/ASV groups following the achievement of viral eradication. The risk for HCC development following viral eradication by IFN-free DAA therapy may be similar to that in IFN-based therapy.