Effectiveness of hepatitis C antiviral treatment in a USA cohort of veteran patients with hepatocellular carcinoma

Beste, Lauren A.; Green, Pamela K.; Berry, Kristin; Kogut, Matthew J.; Allison, Stephen K.; Ioannou, George N.

doi:10.1016/j.jhep.2017.02.027

Cited by 130 publications

(142 citation statements)

References 40 publications

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“…Similar results were confirmed by Prenner et al [47,49], who showed that the presence of active HCC had a negative impact on achieving SVR. Moreover, the failure to obtain a SVR after DAAs may predict the occurrence of HCC [47]. Based on these studies, due to a higher probability of achieving SVR, the patients with HCV related cirrhosis who developed HCC should be treated with DAAs after the tumor complete response has been achieved.…”

Section: Molecular Mechanisms Of Hcc Occurrence or Recurrence With Dasupporting

confidence: 86%

“…The [48]. Similar results were confirmed by Prenner et al [47,49], who showed that the presence of active HCC had a negative impact on achieving SVR. Moreover, the failure to obtain a SVR after DAAs may predict the occurrence of HCC [47].…”

Section: Molecular Mechanisms Of Hcc Occurrence or Recurrence With Dasupporting

confidence: 78%

“…A very recent study has investigated the predictive role of the natural killer group 2 member D (NKG2D), an activating receptor for the MHC class I chain-related protein A/B (MICA/B) and other ligands [47]. NKG2D is a well known immunoreceptor with implications in activating the immune responses against both infected and transformed cells.…”

Section: Molecular Mechanisms Of Hcc Occurrence or Recurrence With Damentioning

confidence: 99%

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Hepatocellular Carcinoma Occurrence and Recurrence after Antiviral Treatment in HCV-Related Cirrhosis. Are Outcomes Different after Direct Antiviral Agents? A Review

Spârchez

Mocan²

2017

JGLD

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Hepatitis C virus (HCV) infection is one of the major causes of hepatocellular carcinoma (HCC) worldwide. In the last decades, several studies have showed a lower rate of HCC occurrence or recurrence in patients with HCV-related cirrhosis after interferon-based antiviral therapies compared to untreated controls, even without reaching viral clearance. Unfortunately, interferon regimens could only yield viral clearance in approximately half of the patients. The recent development of new all-oral regimens with direct-acting antivirals (DAAs) has radically improved the cure rate to above 90%. In respect to these findings, many would have thought that interferon-free regimens would decrease the development and recurrence of HCC. Literature data have unexpectedly reported high rates of both the occurrence and recurrence of HCC after therapy with DAAs. However, it is probably too early to express some concerns. More recent data showed that both occurrence and recurrence of HCC are decreased by the DAAs. Interferon-free therapy is definitely not without limits. Together with the initial thoughts of an increased risk of HCC, these may lead to an unwanted restricted access to interferon-free regimens in specific subpopulations. This issue should be settled as soon as possible because millions of hepatitis C patients are and will be using DAAs in the present and future. Our purpose is to review the existing literature and to offer a more precise and rational interpretation of the existing data.Key words: – – e – .Abreviations: AFP: alpha-fetoprotein; DAA: direct antiviral agent; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; HR: hazard ratio; IFN: interferon; LDV: Ledispavir; SMV: Simeprevir; SOF: Sofosbuvir; SVR: sustained virologic response.

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Section: Molecular Mechanisms Of Hcc Occurrence or Recurrence With Dasupporting

confidence: 86%

Section: Molecular Mechanisms Of Hcc Occurrence or Recurrence With Dasupporting

confidence: 78%

Section: Molecular Mechanisms Of Hcc Occurrence or Recurrence With Damentioning

confidence: 99%

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Hepatocellular Carcinoma Occurrence and Recurrence after Antiviral Treatment in HCV-Related Cirrhosis. Are Outcomes Different after Direct Antiviral Agents? A Review

Spârchez

Mocan²

2017

JGLD

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“…It is also a semi-closed system with a relatively stable patient population, making long-term studies possible. 10,11 …”

Section: Introductionmentioning

confidence: 99%

Barriers to hepatitis C treatment in the era of direct‐acting anti‐viral agents

Lin

Kramer

White

et al. 2017

Aliment Pharmacol Ther

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BACKGROUND Direct-acting antivirals (DAA) are safe, effective treatment of hepatitis C virus (HCV). Suboptimal linkage to specialists and access to DAAs are the leading barriers to treatment; however, data are limited. AIM Determine predictors of follow-up, receipt of DAAs, and reasons for the lack thereof. METHODS We used clinical data from retrospective cohort of HCV-infected patients with previously established HCV care in the US Department of Veterans Affairs to examine predictors of follow-up in HCV clinics and DAA treatment (during 12/1/2013–4/30/2015). We then conducted a structured review of medical charts of HCV patients to determine reasons for lack of follow-up and treatment. RESULTS We identified 84,221 veterans who were previously seen in HCV clinics during the pre-DAA era. Of these, 47,165 (56.0%) followed-up in HCV specialty clinics, 13,532 (28.7%) of whom received DAAs. Older age, prior treatment, presence of cirrhosis or HCC, HIV/HBV co-infection, and psychiatric illness were predictors of follow-up. Alcohol/drug abuse and medical comorbidity were predictors of lack of treatment. Of the 905 prospectively recruited patients, 56.2% patients had a specialist visit and 28% received DAAs. Common reasons for lack of follow-up were relocation (n=148, 37.4%) and missed/cancelled appointments (n=63, 15.9%). Reasons for lack of treatment included waiting for newer therapy (n=99, 38.8%), co-morbidities (n=66, 25.9%), and alcohol/drug abuse (n=63, 24.7%). CONCLUSIONS Half of patients with established HCV care were followed-up in the DAA era and only 29% received DAAs. Targeted efforts focusing on patient and system-levels may improve the reach of treatment with the new DAAs.

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“…Moreover, another study from the same cohort analyzed the SVR sates among patients with and without HCC. The rate of SVR was higher in patients with HCC (74.4%) compared with those without HCC (94%) (14).…”

mentioning

confidence: 86%

Direct acting antiviral agents and hepatocellular carcinoma development: don’t take it for granted

Buonomo

Gentile

Borgia

2017

Transl. Gastroenterol. Hepatol.

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Effectiveness of hepatitis C antiviral treatment in a USA cohort of veteran patients with hepatocellular carcinoma

Abstract: Over three-quarters of patients with hepatocellular carcinoma who have hepatitis C can achieve viral cure with direct-acting antiviral drugs. Among patients with hepatocellular carcinoma who subsequently received liver transplantation, over 90% of patients can achieve viral cure.

Cited by 130 publications

References 40 publications

Hepatocellular Carcinoma Occurrence and Recurrence after Antiviral Treatment in HCV-Related Cirrhosis. Are Outcomes Different after Direct Antiviral Agents? A Review

Hepatocellular Carcinoma Occurrence and Recurrence after Antiviral Treatment in HCV-Related Cirrhosis. Are Outcomes Different after Direct Antiviral Agents? A Review

Barriers to hepatitis C treatment in the era of direct‐acting anti‐viral agents

Direct acting antiviral agents and hepatocellular carcinoma development: don’t take it for granted

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