Hepatocellular Carcinoma (HCC) in HCV-Related Liver Cirrhosis After Sustained Viral Response (SVR)

Authors

  • Author- Syed Hasnain Abbas, Azhar Hussain, Hafiz Fahad Ullah Saeed, Muhammad Usman, Madho Mal, Usman Ismail, Muhammad Umair, Muhammad Furqan, Talal Khurshid Bhatti, Ejaz Shah

Abstract

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.

Methods

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.

Conclusion

 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)

Keywords:

Liver cirrhosis, sustained viral response, hepatocellular carcinoma (HCC)

Published

2023/02/13