The impact of interferon‐free direct‐acting antivirals on clinical outcome after curative treatment for hepatitis C virus–associated hepatocellular carcinoma: Comparison with interferon‐based therapy

• Published in: Journal of medical virology 2019-04, Vol.91 (4), p.650-658
• Main Authors: Nagaoki, Yuko, Imamura, Michio, Nishida, Yuno, Daijo, Kana, Teraoka, Yuji, Honda, Fumi, Nakamura, Yuki, Morio, Kei, Fujino, Hatsue, Nakahara, Takashi, Kawaoka, Tomokazu, Tsuge, Masataka, Hiramatsu, Akira, Kawakami, Yoshiiku, Miki, Daiki, Hiyama, Yuichi, Ochi, Hidenori, Chayama, Kazuaki, Aikata, Hiroshi
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Antiviral agents; Antiviral Agents - therapeutic use; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - therapy; Case-Control Studies; Female; Hepatitis; Hepatitis C; hepatitis C virus (HCV); Hepatitis C, Chronic - complications; Hepatitis C, Chronic - drug therapy; Hepatocellular carcinoma; hepatocellular carcinoma (HCC); Humans; Interferon; Interferons - therapeutic use; Liver cancer; Liver Neoplasms - therapy; Male; Middle Aged; Multivariate analysis; Patients; Recurrence; Retrospective Studies; Survival; Survival Analysis; Sustained Virologic Response; sustained virological response (SVR); Therapy; Treatment Outcome; Virology; Viruses
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.25352

Background and Aim To examine the effect on recurrence and survival of treatment by interferon (IFN)‐free direct‐acting antivirals (DAA) for patients with hepatitis C virus (HCV)‐associated hepatocellular carcinoma (HCC) who underwent primary curative treatment. Methods This was a retrospective cohort study of 250 patients with HCV who had received curative treatment for primary HCC. As anti‐HCV treatment after HCC treatment, 38 patients received IFN‐free DAA therapy (DAA patients) and 94 received IFN‐based therapy (IFN patients). The recurrence of HCC and overall survival of the patient groups were compared in a case‐control study. Results The cumulative HCC recurrence rates at 1, 3, and 5 years were 5%, 39%, and 39% for DAA patients and 0%, 46%, and 62% for IFN patients, respectively (P = 0.370). Multivariate analysis of the HCC recurrence identified treatment responses (sustained virological response [SVR]: hazard ratio [HR] 2.237; P = 0.003) as an independent predictive factor. The cumulative overall survival rates at 3 and 5 years were 96%, 96% for DAA patients and 93%, 73% for IFN patients, respectively ( P = 0.163). Multivariate analysis identified treatment responses (SVR: HR 8.742; P