What is the risk of liver cancer after treatment is successful for hepatitis C?
A new study published in Journal of Hepatology found no evidence for a difference in hepatocellular carcinoma (HCC) occurrence or recurrence after sustained virological response with direct-acting antivirals (DAAs) compared with interferon-based therapy.
In this systematic review, researchers performed meta-analyses and meta-regression on 26 studies of HCC occurrence (interferon [IFN], n = 17; DAA, n = 9) and 17 studies of hepatocellular carcinoma recurrence (IFN, n = 7; DAA, n = 10) after hepatitis C curative therapy. To determine the HCC incidence rate per 100 person-years, random effects meta-analyses were used.
Compared with IFN studies, DAA studies had a shorter follow-up and older average age within the HCC occurrence studies. Researchers found that HCC occurrence was 1.14 per 100 person-years in IFN studies (95% CI, 0.86-1.52) and 2.96 per 100 person-years in DAA studies (95% CI, 1.76-4.96). After adjustment for study follow-up and age, meta-regression revealed no association between higher HCC occurrence and DAAs (relative risk [RR], 0.68; 95% CI, 0.18-2.55; P =.55).
For HCC recurrence studies, those studies investigating DAAs had shorter average follow-up but similar average age compared with IFN studies. Among DAA studies, HCC recurrence was 12.16 per 100 person-years (95% CI, 5.00-29.58) compared with 9.21 per 100 person-years for IFN studies (95% CI, 7.18-11.81). Meta-regression revealed no association between DAA therapy and HCC recurrence (RR, 0.62, 95% CI 0.11-3.45; P =.56).
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