With the introduction of direct-acting antiviral agents (DAA), the rate of sustained virological response (SVR) in the treatment of hepatitis C virus (HCV) has radically improved to over 95%. Robust scientific evidence supports a beneficial role of SVR after interferon therapy in the progression of cirrhosis, resulting in a decreased incidence of hepatocellular carcinoma (HCC). However, a debate on the impact of DAAs on the development of HCC is ongoing. This review aimed to analyse the scientific literature regarding the risk of HCC in terms of its recurrence and occurrence after the use of DAAs to eradicate HCV infection. Among 11 studies examining HCC occurrence, the de novo incidence rate ranged from 0 to 7.4% (maximum follow-up: 18 mo). Among 18 studies regarding HCC recurrence, the rate ranged from 0 to 54.4% (maximum "not well-defined" followup: 32 mo). This review highlights the major difficulties in interpreting data and reconciling the results of the included studies. These difficulties include heterogeneous cohorts, potential misclassifications of HCC prior to DAA therapy, the absence of an adequate control group, short follow-up times and different kinds of follow-up. Moreover, no clinical feature-based scoring system accounts for the molecular characteristics and pathobiology of the tumours. Nonetheless, this review does not suggest that there is a higher rate of de novo HCC occurrence or recurrence after DAA therapy in patients with previous HCV infection.

Guarino, M., Sessa, A., Cossiga, V., Morando, F., Caporaso, N., Morisco, F., et al. (2018). Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows. WORLD JOURNAL OF GASTROENTEROLOGY, 24(24), 2582-2595 [10.3748/wjg.v24.i24.2582].

Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows

Guarino, Maria;Maria, Rendina;Lenci, Ilaria;Manzia, Tommaso Maria;
2018

Abstract

With the introduction of direct-acting antiviral agents (DAA), the rate of sustained virological response (SVR) in the treatment of hepatitis C virus (HCV) has radically improved to over 95%. Robust scientific evidence supports a beneficial role of SVR after interferon therapy in the progression of cirrhosis, resulting in a decreased incidence of hepatocellular carcinoma (HCC). However, a debate on the impact of DAAs on the development of HCC is ongoing. This review aimed to analyse the scientific literature regarding the risk of HCC in terms of its recurrence and occurrence after the use of DAAs to eradicate HCV infection. Among 11 studies examining HCC occurrence, the de novo incidence rate ranged from 0 to 7.4% (maximum follow-up: 18 mo). Among 18 studies regarding HCC recurrence, the rate ranged from 0 to 54.4% (maximum "not well-defined" followup: 32 mo). This review highlights the major difficulties in interpreting data and reconciling the results of the included studies. These difficulties include heterogeneous cohorts, potential misclassifications of HCC prior to DAA therapy, the absence of an adequate control group, short follow-up times and different kinds of follow-up. Moreover, no clinical feature-based scoring system accounts for the molecular characteristics and pathobiology of the tumours. Nonetheless, this review does not suggest that there is a higher rate of de novo HCC occurrence or recurrence after DAA therapy in patients with previous HCV infection.
Pubblicato
Rilevanza internazionale
Recensione
Esperti anonimi
Settore MED/18 - Chirurgia Generale
English
Direct-acting antiviral agents; Hepatitis C virus; Hepatocellular carcinoma; Occurrence; Recurrence; Antiviral Agents; Carcinoma, Hepatocellular; Disease Progression; Hepacivirus; Hepatitis C, Chronic; Humans; Incidence; Liver; Liver Neoplasms; Neoplasm Recurrence, Local; Risk Factors; Sustained Virologic Response; Treatment Outcome; Gastroenterology
https://www.f6publishing.com/forms/main/DownLoadFile.aspx?Type=Digital&TypeId=1&id=10.3748%2fwjg.v24.i24.2582&FilePath=77AD0785A3FF5EE9CBE56CB8F1ADAFAD26BFCDBAC66F5FFAB3BA24E1964ADA6F0BDDD174FCD54C870D01B4F0603BDD84AFAC59DAF125038C
Guarino, M., Sessa, A., Cossiga, V., Morando, F., Caporaso, N., Morisco, F., et al. (2018). Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows. WORLD JOURNAL OF GASTROENTEROLOGY, 24(24), 2582-2595 [10.3748/wjg.v24.i24.2582].
Guarino, M; Sessa, A; Cossiga, V; Morando, F; Caporaso, N; Morisco, F; Luca, V; Romana, Pf; Maurizio, P; Cillo, U; Burra, P; Mescoli, C; Gambato, M; Paolo, Rf; Alessandro, V; Giuseppe, C; Mauro, V; Giovanni, G; Erica, V; Lupo, Lg; Rendina, Lm; Losito, F; Fucilli, F; Persico, M; D'Ambrosio, R; Sangiovanni, A; Massimo, I; Giuseppina, B; Cucchetti, A; Renzulli, M; Franco, T; Miele, L; Grieco, A; Rapaccini, G; Gasbarrini, A; Sandri, Gbl; Melandro, F; Rossi, M; Quirino, L; Lenci, I; Manzia, Tm; Tortora, R; Di Costanzo, Gg; Ghinolfi, D; Rreka, E; Carrai, P; Simonetti, N; Rodolfo, S; Sposito, C; Bhoori, S; Di Sandro, S; Foschi, Fg; Gardini, Ac; Nicolini, D; Mazzocato, S; Alba, K; Violi, P; Baccarani, U; Pravisani, R; Vincenzi, V
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/209032
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