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Curr Hepatol Rep. 2018 Dec;17(4):377-384. doi: 10.1007/s11901-018-0424-8. Epub 2018 Sep 20.

The impact of direct-acting antiviral therapy for hepatitis C on hepatocellular carcinoma risk.

Author information

Division of Gastroenterology, University of Washington, Seattle WA and Veterans Affairs Puget Sound Healthcare System.
Research and Development, Veterans Affairs Puget Sound Healthcare System, Seattle WA.


Purpose of review:

Direct-acting antiviral agents (DAAs) eradicate hepatitis C virus (HCV) infection in the majority of patients. We critically evaluated the impact of DAAs on hepatocellular carcinoma (HCC) risk, a major complication of HCV infection.

Recent findings:

Large cohort studies show that patients who achieve sustained virologic response (SVR) with DAAs have a significantly lower risk of developing de novo HCC than patients who fail treatment or remain untreated. Furthermore, reduction in HCC risk is similar whether SVR is achieved with DAAs or interferon (IFN). However, DAA-induced SVR does not eliminate HCC risk entirely. Therefore, patients with pre-existing cirrhosis require ongoing surveillance even after SVR is achieved.Early, descriptive, uncontrolled reports suggested that DAAs may increase the risk of recurrent HCC. While studying HCC recurrence presents major methodologic challenges, larger studies containing appropriate comparison control groups largely refuted these concerns.


Recent studies provide evidence that DAA-induced SVR reduces HCC risk.


Direct-acting antiviral; hepatitis C; hepatocellular carcinoma; sustained virologic response

[Available on 2019-12-01]

Conflict of interest statement

Conflict of Interest Feng Su and George N. Ioannou each declare no potential conflict of interest.

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