Incidence of hepatocellular carcinoma one year after direct acting antiviral therapy for treatment of HCV infection in patients with decompensated liver cirrhosis; A multicenter study
Diasty, M., Taha, K., Elgamal, A., Ibrahem, M., El-Emam, O., salama, K., Elmahdi, E. (2022). Incidence of hepatocellular carcinoma one year after direct acting antiviral therapy for treatment of HCV infection in patients with decompensated liver cirrhosis; A multicenter study. EKB Journal Management System, 6.2(2), 11-17. doi: 10.21608/mjvh.2022.234478
Muhammad Diasty; Khaled Taha; Ayman Elgamal; Maha Ibrahem; Ola El-Emam; Kamal salama; Essam Elmahdi. "Incidence of hepatocellular carcinoma one year after direct acting antiviral therapy for treatment of HCV infection in patients with decompensated liver cirrhosis; A multicenter study". EKB Journal Management System, 6.2, 2, 2022, 11-17. doi: 10.21608/mjvh.2022.234478
Diasty, M., Taha, K., Elgamal, A., Ibrahem, M., El-Emam, O., salama, K., Elmahdi, E. (2022). 'Incidence of hepatocellular carcinoma one year after direct acting antiviral therapy for treatment of HCV infection in patients with decompensated liver cirrhosis; A multicenter study', EKB Journal Management System, 6.2(2), pp. 11-17. doi: 10.21608/mjvh.2022.234478
Diasty, M., Taha, K., Elgamal, A., Ibrahem, M., El-Emam, O., salama, K., Elmahdi, E. Incidence of hepatocellular carcinoma one year after direct acting antiviral therapy for treatment of HCV infection in patients with decompensated liver cirrhosis; A multicenter study. EKB Journal Management System, 2022; 6.2(2): 11-17. doi: 10.21608/mjvh.2022.234478

Incidence of hepatocellular carcinoma one year after direct acting antiviral therapy for treatment of HCV infection in patients with decompensated liver cirrhosis; A multicenter study

Medical Journal of Viral Hepatitis
Article 4, Volume 6.2, Issue 2, April 2022, Page 11-17  XML PDF (229.03 K)
Document Type: Original article
DOI: 10.21608/mjvh.2022.234478
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Authors
Muhammad Diasty email 1; Khaled Taha2; Ayman Elgamal3; Maha Ibrahem4; Ola El-Emam5; Kamal salama6; Essam Elmahdi7
1Tropical Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
2Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
3Department of Tropical Medicine, Menoufia University, Menoufia, Egypt.
4Oncology Medicine, Ministry of health, Egypt
5Clinical Pathology Department, Mansoura University, Mansoura, Egypt.
6Clinical Pathology Department, Mansoura University, Mansoura, Egypt
7Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Abstract
Background: Data on the occurrence of hepatocellular carcinoma (HCC) in decompensated cirrhosis following direct-acting antiviral agents (DAAs) remains insufficient. This study aimed to establish the incidence of HCC in patients with sustained virologic response (SVR) following DAA therapy in chronic hepatitis C (CHC) related decompensated cirrhosis.
Materials and methods: This prospective multicenter observational cohort study included 305 HCV patients with decompensated liver cirrhosis without HCC. Patients were divided into two groups. The treatment group included 216 patients who received DAAs while the non-treatment group included 89 patients who refused antiviral therapy. Patients were followed up for at least one year after achieving SVR. In the present study, 230 patients ( 176 in treated group and 54 in non-treated group) continued the study follow-up period of at least one year. SVR was achieved in 90% of patients.
Results: Nine patients (5.1%) in the treatment group and 6 patients (11.11%) in non-treatment group developed HCC during the one-year follow-up period after SVR. DAAs therapy was shown to had no significant effect on reducing of incidence of HCC when compared to non-treated patients (p=0.118), although the treatment group showed significant improvement regarding liver function, INR, creatinine, Child-Turcott-Pugh and MELD scores, variceal bleeding, hepatic encephalopathy and ascites when compared to the non-treatment group at one-year post-treatment.
Conclusions: treatment of HCV-related decompensated liver cirrhosis with DAA therapy does not reduce the incidence of HCC after one year of follow-up in spite of patients achieving excellent SVR response and showing significant reduction in cirrhosis-related complications.
Keywords
Hepatocellular carcinoma; hepatitis C virus; direct-acting antiviral agents; sustained virologic response; ascites; alpha fetoprotein
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