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Patients were at no elevated risk of developing hepatocellular carcinoma (HCC) after achieving sustained virologic response (SVR) following treatment with direct-acting antiviral therapy (DAA) for hepatitis C compared to interferon therapy, according to results of a meta-analysis reported at the 2017 International Liver Congress (ILC).
The data reflected that there was no difference in liver cancer risk following cure with either therapy. However, achieving SVR does lower the risk of HCC.
“The best HCC prevention is to scale up hepatitis treatment to achieve SVR and to stop patients from progressing to cirrhosis,” said Gregory J. Dore, MBBS, PhD, head of the Hepatitis Viral Clinical Research Program at the Kirby institute, UNSW Sydney, Australia.
“Recent studies have reported contradicting evidence on the risk of hepatocellular carcinoma following direct-acting antiviral therapy; our aim was to bring some clarity to this,” commented Dore.
“The higher incidence of HCC occurrence and recurrence following DAA therapy can be explained by a shorter duration of follow-up or cohort effect, and older aged patients with a higher base-line risk in this group,” said Dore. “The interferon and DAA studies were not addressing the same patient population—there is a classic cohort effect with the DAA cohort including higher risk patients who had been untreatable with interferon.”