Assessment of hepatocellular carcinoma risk based on peg-interferon plus ribavirin treatment experience in this new era of highly effective oral antiviral drugs

Lee, Seung Ho; Jin, Young–Joo; Shin, Junyoung; Lee, Jin Woo

doi:10.1097/md.0000000000005321

Cited by 9 publications

(11 citation statements)

References 38 publications

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“…Antiviral treatment and resultant SVR improve the long-term clinical outcome of HCV patients[23-28]. The beneficial effects of IFN-based treatment and SVR on reducing cirrhosis progression, HCC, and mortality have been well documented, and this is reflected by the recently published results from two large-scale studies in Asia and two Chinese cohort studies[29-32]. Similar clinical benefits have been observed with SVR to DAA-based treatment.…”

Section: Clinical Benefits Of Curing Hcv Infectionmentioning

confidence: 95%

Hepatitis C virus cure with direct-acting antivirals: Clinical, economic, societal and patient value for China

Xie¹,

Xuan²,

Tang³

et al. 2019

WJH

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About 10 million people in China are infected with hepatitis C virus (HCV), with the seroprevalence of anti-HCV in the general population estimated at 0.6%. Delaying effective treatment of chronic hepatitis C (CHC) is associated with liver disease progression, cirrhosis, hepatocellular carcinoma, and liver-related mortality. The extrahepatic manifestations of CHC further add to the disease burden of patients. Managing CHC-related advanced liver diseases and systemic manifestations are costly for both the healthcare system and society. Loss of work productivity due to reduced well-being and quality of life in CHC patients further compounds the economic burden of the disease. Traditionally, pegylated-interferon plus ribavirin (PR) was the standard of care. However, a substantial number of patients are ineligible for PR treatment, and only 40%–75% achieved sustained virologic response. Furthermore, PR is associated with impairment of patient-reported outcomes (PROs), high rates of adverse events, and poor adherence. With the advent of direct acting antivirals (DAAs), the treatment of CHC patients has been revolutionized. DAAs have broader eligible patient populations, higher efficacy, better PRO profiles, fewer adverse events, and better adherence rates, thereby making it possible to cure a large proportion of all CHC patients. This article aims to provide a comprehensive evaluation on the value of effective, curative hepatitis C treatment from the clinical, economic, societal, and patient experience perspectives, with a focus on recent data from China, supplemented with other Asian and international experiences where China data are not available.

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Section: Clinical Benefits Of Curing Hcv Infectionmentioning

confidence: 95%

Hepatitis C virus cure with direct-acting antivirals: Clinical, economic, societal and patient value for China

Xie¹,

Xuan²,

Tang³

et al. 2019

WJH

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“…HCC develops in hepatitis C patients mostly in the setting of advanced fibrosis and liver cirrhosis [13] . For patients without pre-existing cirrhosis, a higher Fibrosis-4 (FIB-4) index translates to a higher risk of HCC [39] .…”

Section: Advanced Fibrosis and Cirrhosismentioning

confidence: 99%

“…The cumulative risk of HCC development is higher in subjects with high HCV RNA titer than subjects with low titer [45] . SVR results in significantly more favorable long-term outcomes, and decreased risk of progression to cirrhosis and HCC [13,57] . Indeed, a meta-analysis showed that SVR after treatment at any stage of fibrosis is associated with reduced HCC risk [58] .…”

Section: Non-response To the Therapymentioning

confidence: 99%

Factors predicting hepatocellular carcinoma in hepatitis C infection

Abbas¹,

Abbas²

2018

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Hepatitis C virus (HCV) has emerged as a leading cause of hepatocellular carcinoma (HCC). In most cases, the virus causes HCC in the presence of chronic hepatic inflammation, advanced fibrosis, and cirrhosis. A combination of viral, environmental, and genetic factors are likely to determine the host immune response to the infection as well as the progression to HCC. Clinical and epidemiologic studies have identified many of the risk factors associated with HCC development in patients with chronic hepatitis C. Male sex and older age are considered as independent risk factors for HCC, while alcohol consumption accelerates fibrosis, increasing the risk for progression to HCC. Obesity, diabetes mellitus, nonalcoholic fatty liver disease, aflatoxin exposure and occult hepatitis B infection, all contribute to a higher HCC risk. HCV patients infected with HCV genotype 3 are also more likely to develop HCC and genetic variations such as single nucleotide polymorphisms, which may also alter the risk. Sustained virological response to the antiviral therapy results in significantly more favorable long-term outcomes. The incidence of HCC after HCV eradication is similar between patients treated with peginterferon plus ribavirin and direct-acting antiviral therapy.

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“…In the article “Assessment of hepatocellular carcinoma risk based on peg-interferon plus ribavirin treatment experience in this new era of highly effective oral antiviral drugs”, [ 1 ] which appeared in Volume 96, Issue 1 of Medicine , an acknowledgment read “This study was supported by an Inha University Hospital grant”. The statement should have read “This study was supported by an Inha University Research grant”.…”

mentioning

confidence: 99%