Detalle Publicación

Time association between hepatitis C therapy and hepatocellular carcinoma emergence in cirrhosis: relevance of non-characterized nodules

Autores: Marino, Z. ; Darne, A.; Lens, S.; Sapena, V.; Diaz, A. ; Belmonte, E.; Perello, C. ; Calleja, J. L. ; Varela, M. ; Rodriguez, M. ; de Lope, C. R.; Llerena, S. ; Torras, X. ; Gallego, A. ; Sala, M.; Morillas, R. M. ; Minguez, B. ; Llaneras, J. ; Coll, S.; Carrion, J. A. ; Iñarrairaegui Bastarrica, Mercedes; Sangro Gómez-Acebo, Bruno Carlos; Vilana, R.; Sole, M.; Ayuso, C.; Rios, J. ; Forns, X.; Bruix, J. ; Reig, M. (Autor de correspondencia)
Título de la revista: JOURNAL OF HEPATOLOGY (ONLINE)
ISSN: 0168-8278
Volumen: 70
Número: 5
Páginas: 874 - 884
Fecha de publicación: 2019
Background & aims: Despite direct-acting antivirals being highly effective at eradicating hepatitis C virus infection, their impact on the development of hepatocellular carcinoma (HCC) remains controversial. We analyzed the clinical and radiological outcome of cirrhotic patients treated with interferon-free regimens to estimate the risk of developing HCC. Methods: This was a retrospective multicenter study focusing on cirrhotic patients treated with direct-acting antivirals until December 2016. Clinical and radiologic characteristics were collected before the start of antiviral therapy, at follow-up and at HCC development. Diagnosis of HCC was centrally validated and its incidence was expressed as HCC/100 person-years. Results: A total of 1,123 patients were included (60.6% males, 83.8% Child-Pugh A) and 95.2% achieved a sustained virologic response. Median time of follow-up was 19.6 months. Seventy-two patients developed HCC within a median of 10.3 months after starting antiviral treatment. HCC incidence was 3.73 HCC/100 person-years (95% CI 2.96-4.70). Baseline liver function, alcohol intake and hepatic decompensation were associated with a higher risk of HCC. The relative risk was significantly increased in patients with non-characterized nodules at baseline 2.83 (95% CI 1.55-5.16) vs. absence of non-characterized nodules. When excluding these patients, the risk remained increased. Conclusion: These data expose a clear-cut time association between interferon-free treatm