Are people with HIV and HCV co-infection who are cured of hepatitis C with DAAs at increased risk for liver cancer?

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People with HIV and hepatitis C virus (HCV) co-infection who are successfully treated for hepatitis C using interferon-free direct-acting antiviral (DAA) therapy do not appear to have an increased likelihood of developing hepatocellular carcinoma (HCC), according to a study presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2017) this month in Seattle.

More HCC cases are being diagnosed among people with co-infection cured of hepatitis C with DAAs compared to the old interferon-based therapy, but this could be due to the fact that more people with advanced liver disease are now being treated, suggested presenter Nicolás Merchante of Hospital Universitario de Valme in Seville, Spain.

However, the authors note that “the proportion of HCC cases diagnosed among people with HIV/HCV co-infection with previous SVR “significantly increased parallel to the arrival of DAA interferon-free strategies.”

“This finding may be, at least partially, explained by the fact that DAAs have allowed treating people at advanced stages of liver disease in which the protective effect of SVR on the risk of HCC could be less marked,” they suggested.

While the potential role of DAAs in HCC development warrants more research, they came to the reassuring conclusion that this study “has not found evidence for an increased incidence of HCC with DAA use.”