Response from Dr. Grebely concerning DAAs & HCC

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Below is a letter from Jason Grebely, PhD, Associate Professor The Kirby Institute, UNSW Sydney, concerning a news item we shared from ILC 2017 reporting on what the authors believed was a relationship between DAAs and HCC Higher Risk of HCC Recurrence Observed Following DAA Therapy for Hepatitis C.  We really appreciate getting feedback from medical professionals on these matters because, although we do our best to present “the truth,” sometimes it’s a bit too complicated for us, and we are do not want to mislead the community – CD.

Dear HepCBC,

I just wanted to reach out about this whole issue about HCC occurrence and recurrence following DAA therapy.

I was one of the co-authors of the systematic review which you reported on that was published at ILC 2017 which you wrote about (which was a nice article by the way).

I think you need to be really careful about your messaging here as the Spanish data are epidemiologically flawed. The results are being driven by a combination of older age and a cohort effect. Please see a nice article on this here: https://www.medpagetoday.com/meetingcoverage/easl/64704

There are now considerable data from our systematic review and other papers published at ILC 2017 to suggest that this is not the case.

I think it is unfair to say that “Since then, updated results….” as the results were presented at the same conference and this was one paper among a sea of other papers essentially all saying there is no risk of increased HCC occurrence or recurrence among people receiving DAAs. It makes it sound like new data is calling into question the systemic review, which just isn’t the case. This is unnecessarily putting fear in patients based on poor data and bad epidemiology. (Note from CD: The “since then” referred to the fact that the Spanish Study was only made available on the web after we had posted the systematic review, and we felt that since both were presented at ILC 2017 we would share both with our readers).

I will send this to you once accepted and published and I hope that the messaging to patients is that the available evidence suggests that DAAs DO NOT lead to increased risk of HCC occurrence or recurrence.

Thanks for your consideration if this request.

Regards,

Jason Grebely, PhD
Associate Professor
The Kirby Institute, UNSW Sydney