Scientists call for close monitoring of Hepatitis C virus patients prescribed direct-acting antivirals, particularly for those with a history of liver cancer
April 13, 2016, Barcelona, Spain: Data from a new study show that patients with Hepatitis C virus (HCV) taking direct-acting antiviral treatments (DAAs), who have previously fought off hepatocellular carcinoma (HCC), the most common form of liver cancer,1 had a ‘high rate’ of re-developing their illness. The large retrospective cohort study, presented today at The International Liver CongressTM in Barcelona, Spain found 29% of patients who had a history of HCC re-developed the condition during or after taking DAAs.
According to the World Health Organization, liver cancer accounts for 662,000 deaths and is the third leading cause of cancer-related death, exceeded only by cancer of the lung and stomach.2 Approximately 75% to 80% of cases of HCC occur in Asia, however, there is considerable variation within continents.2 The overwhelming majority of HCC cases occur in patients with chronic liver disease, where approximately 80% to 90% have cirrhosis (scarring of liver tissue), and most of the remainder have moderate to advanced fibrosis (an accumulation of scar tissue in the liver).2
“Even in a relatively short observation period, we have shown that high recurrence rates of hepatocellular carcinoma can occur in Hepatitis C patients taking direct-acting antivirals,” said Dr Federica Buonfiglioli, DIMEC, University of Bologna, Italy and study author. “Even though further investigation is needed, we believe our findings justify close monitoring for all cirrhotic patients on such treatments.”
In the Italian study, medical records of 344 HIV-negative patients with HCV related cirrhosis, who did not have active HCC, were analysed. All patients had received treatment with one of the following DAA combinations: sofosbuvir and simeprevir (34%), 3D combination* (22%), sofosbuvir and ribavirin (17%), sofosbuvir and daclatasvir (16%) and sofosbuvir and ledipasvir (10%). Occurrences of HCC were assessed by comparing baseline enhanced-ultrasonography and MRI/CT-scans with those taken during the six month post treatment follow-up.
Sustained virologic response was achieved in 89% of patients at 12 weeks post treatment. At 24 weeks post treatment, active HCC was detected in 7.6% of all patients (n=26) without a history of HCC – deemed to be a ‘standard rate’ by the study authors. However, in the 59 patients who had a previous history of HCC, a ‘high rate’ of 29% (n=17) redeveloped the condition.
“These initial findings provide important insight to how Hepatitis C management strategies could be developed to detect HCC early in patients who are most at risk,” said Professor Laurent Castera, EASL Secretary General. “These findings deserve further investigation given their clinical significance.”
* 3D combination consists of ABT-450 with ritonavir (ABT-450/r), the NS5A inhibitor ombitasvir, and the nonnucleoside polymerase inhibitor dasabuvir and ribavirin
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About The International Liver Congress™
This annual congress is the biggest event in the EASL calendar, attracting scientific and medical experts from around the world to learn about the latest in liver research. Attending specialists present, share, debate and conclude on the latest science and research in hepatology, working to enhance liver disease in clinical practice. This year, the congress is expected to attract approximately 10,000 delegates from all corners of the globe. The International Liver Congress™ takes place from April 13 – 17, 2016, at the Fira Barcelona Gran Via, Barcelona, Spain.
About EASL (www.easl.eu)
Since EASL’s foundation in 1966, this not-for-profit organisation has grown to over 4,000 members from from all over the world, including many of the leading hepatologists in Europe and beyond. EASL is the leading liver association in Europe, having evolved into a major European Association with international influence, with an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.
For more information, please contact the ILC Press Office at:
- Email: ILCpressoffice@ruderfinn.co.uk
- Telephone: +44 (0)7841 009 252
Onsite location reference
Late breaker poster session, Hall 8.1
Thursday 14 April, 08:00 – Saturday 16 April, 18:00
Presenter: Federica Buonfiglioli, Italy
Abstract: LBP506, Development of Hepatocellular Carcinoma in HCV Cirrhotic Patients Treated With Direct Acting Antivirals
Author disclosures of interest
Gilead Sciences (Research Grant, Advisory Board), Janssen (Advisory Board)
1 MedlinePlus. Liver cancer – hepatocellular carcinoma. Available from: https://www.nlm.nih.gov/medlineplus/ency/article/000280.htm. Last accessed: March 2016.
2 US National Library of Medicine National Institutes of Health. Hepatocellular carcinoma: management of an increasingly common problem. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446418/. Last accessed: March 2016.