Age, comorbidities greater impact on HCC rates than DAA therapy
Researchers found no evidence of increased rates of de novo or recurrent hepatocellular carcinoma following treatment with direct-acting antivirals compared with patients treated with interferon therapy, according to a presentation at the World Congress of Gastroenterology at ACG 2017.
Stephanie Rutledge, MBBCh, BAO, MRCPI, presented results of a systematic review and meta-analysis designed to compare rates of HCC after hepatitis C treatment. According to Rutledge and colleagues, recent studies have revealed unexpectedly high rates of HCC after DAA therapy.
The researchers selected 18 studies of patients (n = 12,650) treated with DAA therapy and 22 studies of patients (n = 23,874) treated with interferon therapy to determine de novo HCC incidence. They also included 14 studies (n = 1,056) and eight studies (n = 189) that evaluated recurrent HCC incidence after DAA and interferon therapy, respectively.
The rate of de novo HCC was 5.86 per 100 person-years (95% CI, 0.85-13.08) in the DAA-treated cohort vs. 1.22 per 100 person-years (95% CI, 0.16-3.06) in the interferon-treated group. Similarly, the rate of HCC recurrence was higher among DAA-treated patients (25.34; 95% CI, 6.52-48.7) than interferon-treated patients (20.04; 95% CI, 2.58-45.21).
Compared with the interferon-treated cohort, the DAA-treated group had higher rates of cirrhosis (76% vs. 33%; P = .003) including Child-Pugh stages B and C (23% vs. 3%; P = .004), were older (62 vs. 52 years; P = .004), and more likely to have diabetes (23% vs. 12.5%; P = .04).
After both unadjusted and adjusted analysis, researchers found no significant difference between DAA therapy and interferon therapy for rates of de novo or recurrent HCC. The imbalance of age and comorbidities, according to the researchers, appeared to explain the higher numerical incidence of HCC after DAA therapy, the concluded. – by Talitha Bennett
Rutledge S, et al. Abstract 57. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13-18, 2017; Orlando, FL.
Disclosure: Rutledge reports no relevant financial disclosures.