- HCV therapy with direct-acting antivirals (DAAs) does not accelerate or prevent early recurrence of hepatocellular carcinoma (HCC).
- Waiting ≥12 months between HCC treatment and antiviral therapy may be advisable.
Why this matters
- The potential risk for DAA-induced HCC recurrence remains controversial.
- Patient factors and DAA timing may be contributing factors, irrespective of DAA response.
- French case-control study of 71 patients with HCV-related compensated cirrhosis and complete response to HCC treatment.
- DAA-treated patients (n=22) were matched 1:2 with 49 non-treated patients based on age, sex, liver function, cancer stage, and treatment.
- Median time to DAA initiation, 12 months.
- Funding: None.
- Most initial HCC was Barcelona Clinic Liver Cancer stage A (DAA-treated, 95%; non-treated, 94%).
- HCV-1 was the most common genotype (82%, 86%).
- Rate of sustained virologic response was 86%.
- DAA-treated and non-treated patients had similar HCC recurrence rate (41% vs 35%; P=.7904), time to progression (12 months vs 14 months; P=.7688), and clinical characteristics on progression.
- Median time interval between HCC treatment and DAA therapy was significantly shorter among patients with vs without HCC recurrence (7.0 months vs no recurrence, 36.0 months; P=.0235).
- No DAA-treated patients died from liver failure (vs non-treated, 30%).
- Small, retrospective, monocentric study.