Treatment efficacy for patients with chronic hepatitis C and preexisting hepatocellular carcinoma by directly acting antivirals

Abstract

Aim: Despite the high cure rate of interferon-free directly acting antivirals (DAAs) for chronic hepatitis C (CHC) patients, the treatment efficacy for patients with preexisting hepatocellular carcinoma (HCC) remains undefined. We aimed in the present study to address the issue by using novel DAAs in treating CHC patients who were adherent to treatment in Taiwan.

Methods: CHC patients with or without HCC were consecutively enrolled. The primary objective was sustained virological response (SVR) defined as undetectable HCV RNA throughout 12 weeks of a post-treatment follow-up period (SVR12). Only patients with available SVR12 were enrolled for final analysis.

Results: A total of 1237 patients (1113 non-HCC, 101 inactive HCC and 23 active HCC) were enrolled. The overall SVR12 rate was 98.9%, and was similar between HCV patients with and without pre-existing HCC (98.4% vs. 98.9%, P = 0.64). While HCC patients were classified as those who had active or inactive HCC, the SVR12 was also similar between patients with and without active HCC (95.7% vs. 99.0%, P = 0.34). Among the 101 patients without viable HCC at the time of DAA initiation, eighty-four patients exhibited curative therapy and the other 17 patients experienced HCC recurrence before DAAs. Among the 23 patients with viable HCC at the time of DAA treatment, 10 patients had received curative therapy for HCC whereas the remaining 13 patients had HCC that was never cured. The SVR12 rates were also similar among the four subpopulations, being 98.8% (83/84), 100% (17/17), 90% (9/10) and 100% (13/13) respectively.

Conclusion: CHC patients with HCC who were adherent to potent DAAs achieved similar SVR12 rate compared to those without HCC and could be effectively treated.

Keywords

Directly acting antiviral / chronic hepatitis C / hepatitis C virus / hepatocellular carcinoma / sustained virological response

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