- Direct-acting antiviral (DAA) treatment significantly improves survival in patients with HCV cirrhosis who have undergone curative treatment for early hepatocellular carcinoma (HCC).
Why this matters
- The survival benefit appears to be driven by reduced risk for hepatic decompensation.
- Prospective RESIST-HCV data for 163 patients with HCV cirrhosis (Child-Pugh class A, 84%) treated with DAAs after achieving complete radiologic response with resection/ablation for early-stage HCC.
- Control group consisted of 328 DAA-untreated patients from the ITA.LI.CA cohort.
- Analysis included 102 propensity-matched pairs (mean age, ~71 years).
- Funding: RESIST-HCV funded by Gilead, MSD, Abbvie, and BMS.
- Outcomes at median 21.4-month follow-up in the DAA vs no-DAA groups:
- Deaths: 6.9% vs 17.7% (HR=0.39; P=.03).
- Hepatic decompensation: 5.9% vs 13.7% (HR=0.32; P=.02).
- No difference between groups in terms of HCC recurrence: 27.5% vs 37.3% (P=.15).
- Among DAA-treated patients, sustained virologic response (SVR) was the only variable associated with reduced mortality in multivariate analysis (HR=0.02; P<.001>
- SVR was independently associated with reduced HCC recurrence (HR=0.25; P<.001 and hepatic decompensation p=".02).</li">
- Observational design with historical control.
- HCV genotypes, DAA regimens, SVR rates not specified.