Abstract: #997 Increase in Hepatocellular Carcinoma (HCC) in Hepatitis C (HCV) Patients Without Cirrhosis – Sanath K.Allampati, et al.
This study examined the prevalence and trends in HCV-related HCC from 2000 to 2015. Researchers used electronic medical record data obtained from 2,328 subjects diagnosed with HCC; 20% of the subjects did not have cirrhosis at presentation.
Conclusion: HCV-related HCC trended consistently higher. It was more pronounced in the non-cirrhotic group increasing from 9.6% to 21.7%. The researchers recommend screening non-cirrhotic HCV patients for HCC. Additionally, they state that with the advent of DAAs, there is a concern that a large number of HCV-cured patients might potentially go on to develop HCC even though they do not have cirrhosis.
Editorial Comments: Typically, HCV patients who are successfully treated are pronounced cured with no further follow up recommendation. However, this study indicates a potential need for screening HCV-cured patients for HCC. I hope we see guidelines addressing this.
Lucinda Porter, RN, is a long-time contributor to the HCV Advocate and author of “Free from Hepatitis C” and “Hepatitis C One Step at a Time.” She blogs at www.LucindaPorterRN.com and HepMag.com
Source: PS-035 Among Cirrhotic Patients with a Hepatitis C Sustained Viral Response, the Risk of De-novo Hepatocellular Carcinoma Relates to Baseline Factors and Not the Use of Direct Acting Antivirals: Results from a Nationwide Cohort—H. Innes et al.
Study Aims and Results: The current study is a retrospective study (looking back over time) from the period of 1997 to 2017. Importantly, there were no cases of liver cancer prior to treatment in the patients. The patients in the study were treated previously with interferon-based therapies (585 pts) or direct-acting antiviral therapies (272 pts). The patient characteristics included mostly white (92%), male (75%), current smokers (73%), history of IDU (70%) and heavy alcohol users (44%). Nine percent of the interferon-based group and 30% of the interferon-free group had moderate to severe cirrhosis.
Conclusions: The number of people who developed liver cancer in the interferon-based group was 34 (5.8%) and 12 (4.4%) in the direct-acting antiviral (DAA) group. The study didn’t find a difference in the occurrence of liver cancer rates after achieving a cure with an interferon-based therapy or a direct-acting antiviral medication. It is still important that people who are cured and have cirrhosis are followed closely after being cured because liver disease can progress.
Editorial Comments: There are many studies that are looking at disease progression and liver cancer occurrence and reoccurrence after being cured of hepatitis C. Most studies have found that being cured of hepatitis C reduces the risk of serious disease progression, liver cancer and death. Some studies have found a faster disease progression, however, the studies are in the minority. A good recap of studies of liver cancer recurrence was included in a press release issued by the International Liver Conference/EASL. I have included a press release from EASL that details both types of studies for our readership to read and digest. To read click here