JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v4i1.2307 jpsim.v4i1.2307 Original Research Hepatocellular Carcinoma (HCC) in HCV-Related Liver Cirrhosis After Sustained Viral Response (SVR) Abbas Syed Hasnain azharhussain0139@gmail.com * Hussain Azhar Saeed Hafiz Fahad Ullah Usman Muhammad Mal Madho Ismail Usman Umair Muhammad Furqan Muhammad Bhatti Talal Khurshid Shah Ejaz Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh King Edward Medical University, Mayo Hospital, Lahore Liaquat University of Medical & Health Sciences, Jamshoro SZABMU & PIMS, Islamabad HSHS Saint John Hospital Internal Medicine, Springfield, USA *Correspondence: Syed Hasnain Abbas (azharhussain0139@gmail.com) 13 02 2023 2023 4 1 29 34 07 11 2022 15 12 2022 Copyright © 2023 The Author(s) 2023 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

Effectiveness of the direct-acting antivirals (DAAs) regarding the achievement of SVR post-treatment and its impact on the future occurrence of hepatocellular carcinoma (HCC) post-treatment of DAAs in Hepatitis C-related liver cirrhosis.

 Methodology

It was a cohort study that was done on 359 Hepatitis C patients who were given Ribavarin-Sofosfubuvir & Daclatasvir. We experienced 41.1% (158) lost follow-up. Only 86/201 (43.2%) completed follow-up. The study population was divided into two groups (SVR achieved vs didn’t SVR achieve). Each group was further subdivided into two groups: developed HCC or did not develop HCC post-treatment of DAAs.

 Results

86 subjects who had median age of 50.6 ± 10.65 years who completed triple therapy regime and follow-up, were analyzed. The average follow-up period was 45 weeks (24-68 weeks). Out of 86 patients, 81 (94%) achieved SVR12 with triple therapy of Sofosbuvir-Daclasavir plus Ribavirin. Only 2(2.4%) patients out of 81 developed HCC after the achievement of SVR, while 3/5 (60%) of patients developed HCC who did not achieve SVR. The rate of achievement of SVR was quite lower in the group diagnosed with HCC than those who did not develop HCC post-treatment of DAAs (66.6% v 96.8%, p=0.023). HCC occurrence duration was 31-48 weeks after SVR achievement post-treatment of DAAs.

 Conclusions

SVR achieved by Sofosbuvir-Daclasavir plus Ribavirin plus ribavirin decreases the occurrence of HCC but doesn’t eliminate the chances of developing HCC (66.3 %- or 3.3 times lesser risk).

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