Published online Nov 21, 2020. doi: 10.3748/wjg.v26.i43.6770
Peer-review started: July 16, 2020
First decision: September 14, 2020
Revised: September 27, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: November 21, 2020
Processing time: 126 Days and 13.5 Hours
Direct acting antivirals (DAAs) have revolutionized the treatment of hepatitis C virus (HCV) infection, achieving high rates (≥ 95%) of sustained virological response, with a good safety profile and high compliance rates. Consequently, it had been expected that viral clearance will reduce morbidity and mortality rates, as well as the risk of hepatocellular carcinoma (HCC). However, since 2016, concerns have been raised over an unexpected high rate of HCC occurrence and recurrence after DAA therapy, which led to an avalanche of studies with contradictory results. We aimed to review the most recent and relevant articles regarding the risk of HCC after DAA treatment and identify the associated risk factors.
Core Tip: The risk of hepatocellular carcinoma (HCC) occurrence or recurrence in patients with chronic hepatitis C virus (HCV) infection receiving direct acting antivirals (DAAs) has been debated through the last 4 years. Data provided by current literature indicate a decreasing incidence rate of HCC (both de novo and recurrent) in patients with chronic hepatitis C, HCV-related cirrhosis, and HCV-related HCC after achieving sustained virological response with DAAs.