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Data from 2 recent studies indicate that patients infected with hepatitis C virus (HCV) who were treated with direct-acting antiviral (DAA) therapy were more likely to experience a recurrence of hepatocellular carcinoma (HCC) than those who had no previous history of the disease.
Results from a retrospective cohort study indicate that HCC recurrence occurred at a rate of 29% in patients with cirrhosis who had a history of previous HCC compared with 3.2% of patients with no history of HCC. Federica Buonfiglioli, MD, with the DIMEC, University of Bologna, Italy, and colleagues presented their findings in April 2016 at the International Liver Congress in Barcelona, Spain.
“Even in a relatively short observation period, we have shown that high recurrence rates of hepatocellular carcinoma can occur in Hepatitis C patients taking direct-acting antivirals,” commented Dr. Buonfiglioli, lead author of the study. She added, “Even though further investigation is needed, we believe our findings justify close monitoring for all cirrhotic patients on such treatments.”
“I do not think that direct-acting antivirals are directly responsible,” said Stefano Brillanti, MD, senior investigator of the study. “The hypothesis is that immune surveillance may be reduced too rapidly. You have an immediate drop in viremia, but also attenuation of inflammation. I think inflammation is a bad thing in terms of hepatitis progression, but it may be a good thing in terms of controlling cancer.”
In a similar study, Spanish investigators also found a “high rate” of HCC recurrence in patients who had received prior DAA therapy for HCV. The study, led by Maria Reig, MD, of the Barcelona Clinic Liver Cancer (BCLC) Group, IDIBAPS, and the University of Barcelona and colleagues, was first published online on April 8, 2016, in the Journal of Hepatology.