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J Viral Hepat. 2017 Nov;24(11):976-981. doi: 10.1111/jvh.12726. Epub 2017 Aug 3.

The risk of early occurrence and recurrence of hepatocellular carcinoma in hepatitis C-infected patients treated with direct-acting antivirals with and without pegylated interferon: A Belgian experience.

Author information

1
Faculty of Medicine and Life sciences, Hasselt University, Hasselt, Belgium.
2
Department of Gastro-Enterology and Hepatology, Ziekenhuis-Oost Limburg, Genk, Belgium.
3
Department of Gastro-Enterology and Hepatopancreatology, Erasme Hospital, Brussels, Belgium.
4
Department of Hepatology and Gastro-Enterology, University Hospitals Gent, Gent, Belgium.
5
Department of Gastro-Enterology and Hepatology, ZNA Stuivenberg, Antwerp, Belgium.
6
Department of Gastro-Enterology and Hepatology, Hôpital Saint-Pierre, Brussels, Belgium.
7
Department of Gastro-Enterology and Hepatology, Antwerp University Hospital, Edegem, Belgium.
8
Department of Gastroenterology and Digestive Oncology, CHR Citadelle, Liège, Belgium.
9
Department of Gastro-Enterology and Hepatology, AZ Delta, Roeselare, Belgium.
10
Department of Gastro-Enterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium.
11
Department of Gastro-Enterology and Hepatology, Hôpital HIS Bracops, Anderlecht, Brussels, Belgium.
12
Department of Gastro-Enterology and Hepatology, Jessa Hospital, Hasselt, Belgium.
13
Department of Gastro-Enterology and Hepatology, AZ Sint Maarten, Mechelen, Belgium.
14
Department of Gastro-Enterology and Hepatology, AZ Maria Middelares, Gent, Belgium.
15
Department of Gastro-Enterology and Hepatology, AZ Groeninge, Kortrijk, Belgium.
16
Department of Gastro-Enterology and Hepatology, AZ Damiaan, Oostende, Belgium.

Abstract

Recently, concerns were raised of high rates of HCC recurrence in patients treated with direct-acting antivirals (DAA) for hepatitis C infection. We investigated the HCC occurrence and recurrence rates within 6 months after treatment with DAA with or without pegylated interferon (PEG-IFN) in real life. This is a retrospective, multicenter cohort trial, executed in 15 hospitals distributed across Belgium. Populations were matched based on fibrosis score (Metavir F3-F4). Patients with a Child-Pugh score ≥ B were excluded. In total, 567 patients were included, of whom 77 were treated with PEG-IFN+DAA between 2008 and 2013 and 490 with DAA without PEG-IFN between 2013 and 2015. Patients treated with PEG-IFN+DAA (53±9y) were younger than patients treated with DAA without PEG-IFN (59±12y) (P=.001). 47% of patients treated with PEG-IFN+DAA were in the F4 stage vs 67% of patients treated with DAA without PEG-IFN (P=.001). Screening was inadequate in 20% of both patient groups (P=.664). The early occurrence rate of HCC was 1.7% and 1.1% in patients treated with DAA with and without PEG-IFN, respectively (P=.540). The early recurrence rate was 0% in patients treated with PEG-IFN+DAA and 15.0% in patients treated with DAA without PEG-IFN (P=.857). There is no difference in early occurrence of new HCC between patients treated with DAA with and without PEG-IFN. We did observe a high early recurrence rate of HCC in patients treated with DAA without PEG-IFN. However, these patients were at baseline more at risk for HCC. Finally, in 20%, screening for HCC was inadequate.

KEYWORDS:

direct-acting antiviral therapy; hepatitis C; hepatocellular carcinoma; pegylated interferon

PMID:
28504854
DOI:
10.1111/jvh.12726
[Indexed for MEDLINE]

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