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United European Gastroenterol J. 2019 Jun;7(5):699-708. doi: 10.1177/2050640619841254. Epub 2019 Mar 29.

Recurrence rate of hepatocellular carcinoma in patients with treated hepatocellular carcinoma and hepatitis C virus-associated cirrhosis after ombitasvir/paritaprevir/ritonavir+dasabuvir+ribavirin therapy.

Author information

Gastroenterology and Hepatology Department, Clinic Fundeni Institute, Bucharest, Romania.
Internal Medicine Department, Colentina Hospital, Bucharest, Romania.
Surgery Department, Clinic Fundeni Institute, Bucharest, Romania.
Radiology Department, Clinic Fundeni Institute, Bucharest, Romania.
Gastroenterology and Hepatology Department, Elias Emergency Hospital, Bucharest, Romania.



Recent studies have suggested a higher recurrence rate of hepatocellular carcinoma (HCC) in patients with a history of HCC and hepatitis C virus (HCV)-associated cirrhosis treated with direct-acting antiviral (DAA) agents.

Material and methods:

We conducted a prospective analysis of 24 patients with HCV-associated cirrhosis and treated HCC who received ombitasvir/paritaprevir/ritonavir+dasabuvir+ribavirin for 12 weeks. Prior therapies for HCC included resection (9/24 patients), radiofrequency ablation (RFA) (7/24) and trans-arterial chemoembolization (TACE) (8/24). All patients were eligible for treatment if they had no HCC recurrence 6 months after their last procedure. A control group was defined. All patients were followed every 6 months, with dynamic computed tomography and/or magnetic resonance imaging.


The sustained virological response rate per protocol was 21/24 (87.5%). The study group included 14 (59%) males, median age 64 years (51-77), 50% with associated non-alcoholic steatohepatitis and 24% with Child-Pugh A6 points. HCC recurrence rate/100 patient-years was lower in the DAA-HCC group versus control: 5.5 versus 24.6% patient-years for the resection+RFA group (p = 0.044), respectively, and 18.6 versus 72.7% patient-years for TACE group (p = 0.002). Survival without recurrence was higher in the resection+RFA group (45 compared to 18 months (p < 0.001)) and also in the TACE group (44 compared to 11.5 months (p = 0.002)).


DAA therapy significantly reduced the recurrence rate of HCC and improved survival without recurrence in patients with treated HCV-associated HCC.


Hepatitis C; direct antiviral therapy; hepatocellular carcinoma; liver cirrhosis; ombitasvir/paritaprevir/r+dasabuvir+ribavirin

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