HCV Treatment Failure May Lead to Increased Risk of Hepatocellular Carcinoma

Patients with hepatitis C virus (HCV) who achieve a sustained virological response to treatment have a reduced risk of hepatocellular carcinoma (HCC) compared with patients who are untreated, according to the results of a recent analysis.

It is well known that achieving sustained virological response to HCV reduces the risk of HCC. However, little research has explored how treatment failure compares to lack of treatment.
______________________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Research Supports Hep C Treatment for Injection Drug Users
Study: PCPs Could Treat Hepatitis C as Efficiently as Specialists
______________________________________________________________________________________________________________________________________________________________________

To conduct their study, the researchers analyzed data from 10,091 patients with HCV being treated at 4 large health systems in the United States and who were part of the Chronic Hepatitis Cohort Study (CHeCS).

Patients with up to 7 years of follow-up were included in the analysis.

The results showed that 36% of patients were treated for HCV and 57% experienced treatment failure. Overall, 43% of patients achieved sustained virological response.

Patients who had achieved sustained virological response had a reduced risk of HCC compared with those who experienced treatment failure.

Multivariable and sensitivity analyses showed that patients who experienced treatment failure were nearly twice as likely to develop HCC than untreated patients. The same risk was seen across all stages of fibrosis.

African Americans were at an increased risk of treatment failure but were less likely to develop HCC and all-cause mortality than Caucasian patients. Treatment—regardless of outcome—reduced all-cause mortality.

“Patients who fail interferon-based therapy demonstrate a higher risk of HCC than untreated patients, possibly due to interferon-related acceleration of fibrosis in the absence of successful viral eradication,” the researchers concluded.

“Regardless of whether this finding reflects an impaired innate immune responsiveness or an interferon-mediated acceleration of fibrosis, we suggest that such treatment failure patients may represent a cohort of individuals for whom retreatment with new, highly effective direct-acting all-oral antiviral therapies should become a priority.”

—Amanda Balbi

Reference:

Lu M, Li J, Rupp LB, et al. Hepatitis C treatment failure is associated with increased risk of hepatocellular carcinoma. J Viral Hepat. 2016;23(9):718-729. doi:10.1111/jvh.12538.