Muzica CM, Stanciu C, Huiban L, Singeap AM, Sfarti C, Zenovia S, Cojocariu C, Trifan A. Hepatocellular carcinoma after direct-acting antiviral hepatitis C virus therapy: A debate near the end. World J Gastroenterol 2020; 26(43): 6770-6781 [PMID: 33268960 DOI: 10.3748/wjg.v26.i43.6770]
Corresponding Author of This Article
Anca Trifan, FRCP (C), MD, PhD, Doctor, Professor, Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, St. Spiridon Emergency Hospital, University Street 16, Iasi 700115, Romania. ancatrifan@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Nov 21, 2020; 26(43): 6770-6781 Published online Nov 21, 2020. doi: 10.3748/wjg.v26.i43.6770
Hepatocellular carcinoma after direct-acting antiviral hepatitis C virus therapy: A debate near the end
Cristina Maria Muzica, Carol Stanciu, Laura Huiban, Ana-Maria Singeap, Catalin Sfarti, Sebastian Zenovia, Camelia Cojocariu, Anca Trifan
Cristina Maria Muzica, Carol Stanciu, Laura Huiban, Ana-Maria Singeap, Catalin Sfarti, Sebastian Zenovia, Camelia Cojocariu, Anca Trifan, Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, St. Spiridon Emergency Hospital, Iasi 700115, Romania
Author contributions: Trifan A, Stanciu C and Muzica CM contributed to conception and design of the study; Singeap AM, Cojocariu C and Huiban L were involved in the acquisition of data and contributed to the analysis and interpretation of data; Muzica CM, Zenovia S and Stanciu C drafted the manuscript; Sfarti C reviewed the paper; all authors have read and approved the final version of the manuscript; and all authors accept responsibility for its content.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anca Trifan, FRCP (C), MD, PhD, Doctor, Professor, Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy, St. Spiridon Emergency Hospital, University Street 16, Iasi 700115, Romania. ancatrifan@yahoo.com
Received: July 16, 2020 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
Abstract
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.
