De novo hepatocellular carcinoma occurrence in hepatitis C cirrhotics treated with direct-acting antiviral agents

Abstract

Aim: Recent studies raise concerns for higher incidence of hepatocellular carcinoma (HCC) after direct-acting antiviral therapy for hepatitis C virus (HCV). Methods: In this study, using analysis of liver imaging pre- and post-DAA treatment, we queried new occurrence or ‘de novo’ of HCC in patients with HCV-cirrhosis treated with DAAs. Of 150 patients who met study criteria, 7 (4.7%; 95% CI: 2.1–9.5%) patients developed de novo HCC which did not differ from historical rates of 3% (p=0.22). Results: Notably, patients with decompensated cirrhosis had significantly higher rate of de novo HCC (9.3%; 95% CI: 3.12–22.2%; p=0.04). Conclusion: Our data support the need for continued surveillance for HCC in HCV cirrhotics even after successful therapy.

Keywords::

• cirrhosis
• de novo HCC
• direct-acting antivirals
• hepatitis C virus
• hepatocellular carcinoma
• interferon
• LiRADS 4, 5
• liver-directed imaging

Financial & competing interests disclosure

S Sarkar has served on advisory boards for Gilead sciences and Abbvie and received grants (paid to UC Davis) from Gilead Sciences. R Hluhanich has stocks in Gilead Sciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

(Note: The study was approved by the UC Davis Institutional Review Board and exempted from obtaining consents)

Additional information

Funding

S Sarkar has served on advisory boards for Gilead sciences and Abbvie and received grants (paid to UC Davis) from Gilead Sciences. R Hluhanich has stocks in Gilead Sciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.