Hepatocellular Carcinoma Recurrence after Hepatitis C Virus Therapy with Direct-Acting Antivirals. A Systematic Review and Meta-Analysis.

Published on Apr 15, 2021in Journal of Clinical Medicine3.303
· DOI :10.3390/JCM10081694
Leonardo Frazzoni21
Estimated H-index: 21
Usama Sikandar + 5 AuthorsFrancesco Azzaroli20
Estimated H-index: 20
Background: Hepatocellular carcinoma (HCC) is a major cause of morbidity and mortality among patients with cirrhosis. The risk of HCC recurrence after a complete response among patients treated with direct-acting antivirals (DAAs) has not been fully elucidated yet. Aim: To assess the risk of HCC recurrence after DAA therapy for hepatitis C virus (HCV). Methods: A systematic review across PubMed, Scopus and Scholar up to November 2020, including full-text studies that assessed the pattern of HCC recurrence after DAA therapy for HCV. Random-effect meta-analysis and univariable metaregression were applied to obtain pooled estimates for proportions and relative risk (RR) and variables influential for the outcome, respectively. Results: Thirty-one studies with 2957 patients were included. Overall, 30% (CI, 26–34%) of the patients with a history of HCC experienced HCC recurrence after DAA therapy, at mean time intervals ranging from 4 to 21 months. This result increased when going from European studies (23%, CI, 17–28%) to US studies (34%, CI, 30–38%), to Egyptian studies (37%, CI, 27–47%), and to Asian studies (33%, CI, 27–40%). Sixty-eight percent (CI, 45–91%) of recurrent HCCs developed within 6 months of follow-up since DAA treatment, among the eight studies providing stratified data. Among the studies providing head-to-head comparisons, the HCC recurrence risk was significantly lower after DAA therapy than IFN (RR, 0.64; CI, 0.51–0.81), and after DAA therapy than no intervention (RR, 0.68; CI, 0.49–0.94). Conclusions: The recurrence of HCC after DAA is not negligible, being higher soon after the end of treatment and among non-European countries. DAA therapy seems to reduce the risk of HCC recurrence compared to an IFN regimen and no intervention.
#1Chen-Ta Chi (Taipei Veterans General Hospital)H-Index: 2
#2Chi-Yi ChenH-Index: 1
Last. Yi-Hsiang Huang (NYMU: National Yang-Ming University)H-Index: 52
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Abstract Background/Purpose The treatment of chronic hepatitis C (CHC) has evolved from interferon (IFN)-based therapy to direct acting antivirals (DAAs). The effect of antiviral treatment on outcome of hepatocellular carcinoma (HCC) patients with CHC has not been well analyzed in Taiwan. Methods From April 2015 to May 2018, 199 HCC patients with CHC undergoing DAAs treatment, including 127 having prospectively longitudinal observation, were enrolled. Among them, 107 BCLC 0/A patients achieving ...
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#1Hironori OchiH-Index: 18
#2Atsushi HiraokaH-Index: 28
Last. Kouji JokoH-Index: 18
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The effects of direct-acting antivirals (DAAs) on survival and recurrence rates after curative hepatocellular carcinoma (HCC) treatment in patients with hepatitis C virus (HCV) infection remain controversial. This retrospective, multicenter study involved Child–Pugh class A patients within the Milan criteria who had a first diagnosis of HCC and survived 6 months or longer after undergoing hepatectomy or radiofrequency ablation (RFA). The DAA-treated group (DAA group) included 56 patients, and th...
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#1Rania Mohamed Lithy (Cairo University)H-Index: 1
#2Tamer Elbaz (Cairo University)H-Index: 14
Last. Hend Ibrahim Shousha (Cairo University)H-Index: 10
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#1Angelo SangiovanniH-Index: 34
#2Eleonora AlimentiH-Index: 1
Last. Pietro Lampertico (University of Milan)H-Index: 58
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#1Yuki Tahata (Osaka University)H-Index: 5
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Last. Tetsuo Takehara (Osaka University)H-Index: 72
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#1Patrick P. Y. Chan (UNSW: University of New South Wales)H-Index: 2
#2Miriam T. Levy (UNSW: University of New South Wales)H-Index: 21
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#1Wei-Chen Lin (Mackay Memorial Hospital)H-Index: 7
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#1Satoshi Miuma (Nagasaki University)H-Index: 13
#2Junya Miyamoto (Nagasaki University)H-Index: 2
Last. Kazuhiko Nakao (Nagasaki University)H-Index: 3
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#2Jing-Houng Wang (CGU: Chang Gung University)H-Index: 54
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This study was done to elucidate the influence of direct-acting antiviral (DAA) agents on the recurrence of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related HCC (HCV-HCC) after curative therapies. HCV-HCC patients who received curative therapies and obtained a complete response were analyzed. From January 2017 to September 2017, 112 HCV-HCC patients received DAA and obtained a sustained virological response (SVR). From January 2006 to December 2014, another 345 HCV...
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