Prevention of liver cancer with new curative hepatitis C antivirals: Real‐world challenges

Soriano, Vincent; Tefferi, Ayalew

doi:10.1002/cncr.31291

Cited by 14 publications

(12 citation statements)

References 18 publications

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“…The benefits of curing HCV infections are far-reaching [135]. In response to emerging treatments, the WHO commissioned a systematic literature review to inform treatment guidelines for the management of persons with HCV infection.…”

Section: Discussionmentioning

confidence: 99%

Pangenotypic direct acting antivirals for the treatment of chronic hepatitis C virus infection: A systematic literature review and meta-analysis

et al. 2020

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Background: Recent approval and adoption of pangenotypic direct acting antivirals (DAAs) necessitated a revision of the 2015 World Health Organization guidelines for the management of persons with hepatitis C virus (HCV) infection. Methods: We searched MEDLINE, EMBASE, CENTRAL, and relevant conference proceedings to identify randomized and non-randomized trials, as well as prospective observational studies of DAAs. The proportions of persons with events were pooled for sustained virological response at 12 weeks post-treatment (SVR12), discontinuations due to adverse events (DAEs), serious adverse events (SAEs), and all-cause mortality. Analyses were stratified by HCV genotype and antiviral treatment experience, with subgroup analyses based on presence of cirrhosis and HIV-HCV coinfection. Findings: The evidence base consisted of 238 publications describing 142 studies. In the overall analysis, which included all persons irrespective of treatment experience or comorbidities, the pooled proportion achieving SVR12 exceeded 0.94 for all pangenotypic regimens across genotypes 1, 2, and 4. Some heterogeneity may have led to lower SVR rates in persons with genotype 3 infection. High SVR12 (>0.90) was observed in persons with genotype 1 infection with cirrhosis, though evidence varied and was limited for genotypes 2À4. Evidence was sparse for persons with HIVÀHCV coinfection. All regimens were associated with small proportions of persons with DAEs, SAEs, or all-cause mortality. Interpretation: Based on this and other supporting evidence, the WHO issued updated guidelines with a conditional recommendation, based on moderate quality evidence, for the use of pangenotypic DAA regimens for persons with chronic HCV infection aged 18 years and older (July 2018). Funding: This study was funded by the World Health Organization.

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Section: Discussionmentioning

confidence: 99%

Pangenotypic direct acting antivirals for the treatment of chronic hepatitis C virus infection: A systematic literature review and meta-analysis

et al. 2020

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“…Of note, the rate of hepatocellular carcinoma increased four to five-fold during the study period, most likely reflecting the high proportion of chronic viral hepatitis in this population [27]. Since the advent of new direct-acting antivirals a couple of years ago, most chronic hepatitis C patients are cured, and therefore, we should expect a steadily decline in the rate of hepatocellular carcinoma in this population [28].…”

Section: Discussionmentioning

confidence: 99%

Trends in hospitalizations and deaths in HIV-infected patients in Spain over two decades

Ramos-Rincón

Menchi-Elanzi

Pinargote‐Celorio

et al. 2021

Aids

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Background: The prognosis of HIV infection dramatically improved after the introduction of triple antiretroviral therapy 25 years ago. Herein, we report the impact of further improvements in HIV management since then, looking at all hospitalizations in persons with HIV (PWH) in Spain.Methods: A retrospective study using the Spanish National Registry of Hospital Discharges. Information was retrieved since 1997-2018.Results: From 79 647 783 nationwide hospital admissions recorded during the study period, 532 668 (0.67%) included HIV as diagnosis. The mean age of PWH hospitalized increased from 33 to 51 years (P < 0.001). The rate of HIV hospitalizations significantly declined after 2008. Comparing hospitalizations during the first (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) and last (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018) decades, the rate of non-AIDS illnesses increased, mostly due to liver disease (from 35.9 to 38.3%), cardiovascular diseases (from 12.4 to 28.2%), non-AIDS cancers (from 6.4 to 15.5%), and kidney insufficiency (from 5.4 to 13%). In-hospital deaths occurred in 5.5% of PWH, declining significantly over time. Although most deaths were the result from AIDS conditions (34.8%), the most frequent non-AIDS deaths were liver disease (47.1%), cardiovascular events (29.2%), non-AIDS cancers (24.2%), and kidney insufficiency (20.7%). Conclusion:Hospital admissions in PWH significantly declined after 2008, following improvements in HIV management and antiretroviral therapy. Non-AIDS cancers, cardiovascular events and liver disease represent a growing proportion of hospital admissions and deaths in PWH.

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“… 4 , 20 , 21 The cause of Hepatitis C differs between countries. In developing countries, it is mainly due to infections of medical origin, contaminated needles, etc., while in developed countries it is mainly due to exposure to high‐risk factors and injection drug use, unclean sexual practices, etc 22 , 23 The exact association between HCV and liver cancer is unclear. The reasons might be that HCV in the liver causes a high turnover of liver cells by destruction and repairment.…”

Section: Discussionmentioning

confidence: 99%

Global burden of primary liver cancer by five etiologies and global prediction by 2035 based on global burden of disease study 2019

et al. 2022

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Background: Using data from the global burden of disease (GBD) between 1990 and 2019 to report the leading etiological factors and hazards for liver cancer by HBV (LCHB), HCV (LCHC), alcoholic use (LCAL), NASH (LCNA), and other causes (LCOT). Method:The estimated annual percentage change (EAPC) and age-standardized incidence rate (ASR) in different districts, sex, and age are used to quantify the change of etiologies of liver cancer. Age-period-cohort models were performed to predict the primary liver cancer incidence and case numbers.Results: Based on the GBD database of the whole world for the five etiologies of liver cancer in 2019, the percentage of incidence of LCAL, LCHB, LCHC, LCNA, and LCOT are 18.4%, 41%, 28.5%, 6.8%, and 5.3%, respectively. Fiver etiologies of liver cancer show gender differences, with LCHB and LCAL being more prevalent in men, and LCHC, LCNA being more prevalent in women. Besides, live cancer of males is because of alcohol using and smoking, while the reason of liver cancer of females is drug use, high BMI and high fasting plasma glucose. Interestingly, the incidence of LCHC in women over 85 years old, LCNA in women over 75 years old, and LCOT in women over 75 years old were all higher than that in men.According to the future prediction, the incidence rate of liver cancer itself, as well as the five causes of liver cancer, tends to decrease gradually after 2019, while the incidence rate of LCNA in males will continue to increase until 2025. Conclusions:The incidence of liver cancer has been increasing and its major causes vary considerably at global, regional, or national levels, also vary by gender and age group.

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Prevention of liver cancer with new curative hepatitis C antivirals: Real‐world challenges

Cited by 14 publications

References 18 publications

Pangenotypic direct acting antivirals for the treatment of chronic hepatitis C virus infection: A systematic literature review and meta-analysis

Pangenotypic direct acting antivirals for the treatment of chronic hepatitis C virus infection: A systematic literature review and meta-analysis

Trends in hospitalizations and deaths in HIV-infected patients in Spain over two decades

Global burden of primary liver cancer by five etiologies and global prediction by 2035 based on global burden of disease study 2019

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