PLoS ONE (Jan 2017)

The risks of hepatocellular carcinoma development after HCV eradication are similar between patients treated with peg-interferon plus ribavirin and direct-acting antiviral therapy.

  • Yuko Nagaoki,
  • Michio Imamura,
  • Hiroshi Aikata,
  • Kana Daijo,
  • Yuji Teraoka,
  • Fumi Honda,
  • Yuki Nakamura,
  • Masahiro Hatooka,
  • Reona Morio,
  • Kei Morio,
  • Hiromi Kan,
  • Hatsue Fujino,
  • Tomoki Kobayashi,
  • Keiichi Masaki,
  • Atsushi Ono,
  • Takashi Nakahara,
  • Tomokazu Kawaoka,
  • Masataka Tsuge,
  • Akira Hiramatsu,
  • Yoshiiku Kawakami,
  • C Nelson Hayes,
  • Daiki Miki,
  • Hidenori Ochi,
  • Kazuaki Chayama

DOI
https://doi.org/10.1371/journal.pone.0182710
Journal volume & issue
Vol. 12, no. 8
p. e0182710

Abstract

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The risk of hepatocellular carcinoma (HCC) development is reduced following viral elimination by interferon therapy in chronic hepatitis C patients. However, the risk in patients treated with interferon-free direct-acting antivirals (DAAs) is unknown. We evaluated chronic hepatitis C patients who achieved viral eradication by pegylated-interferon plus ribavirin (PEG-IFN/RBV, n = 244) or daclatasvir plus asunaprevir (DCV/ASV, n = 154) therapy. None of the patients had prior history of HCC or antiviral therapy. The median observation period after the end of treatment for the PEG-IFN/RBV and DCV/ASV groups were 96 (range 10-196) and 23 (range 4-78) months, respectively. During the observation period, HCC developed in 13 (5.3%) and 7 (4.5%) patients in the PEG-IFN/RBV and DCV/ASV groups, respectively. The cumulative HCC development rate after 1-, 3- and 5-years (0.4%, 3% and 5% for the PEG-IFN/RBV group and 0.6%, 9% and 9% for the DAA group, respectively) were similar between the two groups. Propensity score matching analysis also showed no significant difference in HCC development rates between the two groups. Serum AFP levels decreased to similar levels between PEG-IFN/RBV and DCV/ASV groups following the achievement of viral eradication. The risk for HCC development following viral eradication by IFN-free DAA therapy may be similar to that in IFN-based therapy.