Systematic review with meta‐analysis: effectiveness of direct‐acting antiviral treatment for hepatitis C in patients with hepatocellular carcinoma

He, Sichan; Lockart, Ian; Alavi, Maryam; Danta, Mark; Hajarizadeh, Behzad; Dore, Greg

doi:10.1111/apt.15598

Cited by 26 publications

(16 citation statements)

References 86 publications

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“…A higher SVR rate was observed in patients who received curative HCC therapy than in those who received non-curative therapy or were not treated. 225 In a retrospective cohort study of 149 liver transplantation candidates with HCV infection and HCC at a single centre, patients treated with DAAs for their HCV infection had lower risk of waitlist dropout due to tumour progression or death compared to the patients who had not been treated. 226 Post-liver transplantation treatment of HCV was reported to be cost-effective in patients with HCC.…”

Section: Treatment Of Chronic Hepatitis C In Patients With Hcc Withoumentioning

confidence: 99%

EASL recommendations on treatment of hepatitis C: Final update of the series☆

Pawlotsky¹,

Negro²,

Aghemo³

et al. 2020

Journal of Hepatology

857

632

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Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. Clinical care for patients with HCV-related liver disease has advanced considerably thanks to an enhanced understanding of the pathophysiology of the disease, as well as developments in diagnostic procedures and improvements in therapy and prevention. These therapies make it possible to eliminate hepatitis C as a major public health threat, as per the World Health Organization target, although the timeline and feasibility vary from region to region. These European Association for the Study of the Liver recommendations on treatment of hepatitis C describe the optimal management of patients with recently acquired and chronic HCV infections in 2020 and onwards.

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Section: Treatment Of Chronic Hepatitis C In Patients With Hcc Withoumentioning

confidence: 99%

EASL recommendations on treatment of hepatitis C: Final update of the series☆

Pawlotsky¹,

Negro²,

Aghemo³

et al. 2020

Journal of Hepatology

857

632

View full text Add to dashboard Cite

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“…In the multivariate analysis, active HCC (vs inactive HCC and non‐HCC) was associated with DAAs failure (OR, 24.5 [95% CI, 4.4‐136.9], P < .001) 27 . Two recently published meta‐analysis confirmed a reduced SVR rate in patients with active HCC when compared with patients with inactive HCC or without HCC 28,29 …”

Section: Discussionmentioning

confidence: 97%

Decompensated cirrhosis and liver transplantation negatively impact in DAA treatment response: Real‐world experience from HCV‐LALREAN cohort

Ridruejo

Piñero

Mendizábal

et al. 2020

Journal of Medical Virology

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Introduction Although the effectiveness of direct‐acting antivirals (DAAs) for the treatment of chronic hepatitis C virus (HCV) has been reported in real‐world settings, predictive factors of treatment failure are lacking. Therefore, we sought to explore the baseline predictors of treatment response to DAAs. Methods This was a prospective multicenter cohort study from the Latin American Liver Research Educational and Awareness Network (LALREAN) including patients who received DAA treatment from May 2016 to April 2019. A multivariate logistic regression model was conducted to identify variables associated with unachieved sustained virological response (SVR), defined as treatment failure (odds ratios [OR] and 95% confidence intervals [CIs]). Results From 2167 patients (55.2% with cirrhosis) who initiated DAA therapy, 89.4% completed a full‐course treatment (n = 1938). Median treatment duration was 12 weeks, and 50% received ribavirin. Definitive suspension due to intolerance or other causes was observed in only 1.0% cases (n = 20). Overall non‐SVR12 was 4.5% (95% CI, 3.5‐5.7). There were no significant differences in treatment failure according to HCV genotypes and the degree of fibrosis. Independently associated variables with DAA failure were liver function impairment according to the Child‐Pugh score B OR, 2.09 (P = .06), Child‐Pugh C OR, 11.7 (P < .0001); and liver transplant (LT) recipient OR, 3.75 (P = .01). Conclusion In this real‐life setting, higher DAA treatment failure rates were observed in patients with decompensated cirrhosis and in LT recipients. These predictive baseline factors should be addressed to individualize the appropriate time‐point of DAA treatment (NCT03775798; http://www.clinicaltrials.gov).

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“…Their authors raise beneficial effects, but only from the point of view of the sustained virological response (SVR) obtained, not precisely referring to results of cancer treatment. Evaluation of long-term results of DAA therapy in this group of patients is necessary [ 23 - 25 ].…”

Section: General Recommendationsmentioning

confidence: 99%