Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 27, 2018; 10(12): 898-906
Published online Dec 27, 2018. doi: 10.4254/wjh.v10.i12.898
Hepatitis C virus-associated hepatocellular carcinoma after sustained virologic response
Reina Sasaki, Tatsuo Kanda, Naoya Kato, Osamu Yokosuka, Mitsuhiko Moriyama
Reina Sasaki, Tatsuo Kanda, Naoya Kato, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
Tatsuo Kanda, Mitsuhiko Moriyama, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Itabashi-ku 173-8610, Japan
Author contributions: All authors contributed to all aspects of this paper.
Conflict-of-interest statement: Sasaki R, Yokosuka O and Moriyama M declare no conflict of interest related to this publication. Kanda T reports grants and other from Abbvie, grants and other from MSD K.K., grants and other from Chugai Pharmaceutical CO., LTD., grants from Sysmex, other from Gilead Sciences, other from Bristol-Myers Squibb, other from Otsuka Pharmaceutical, grants from Daiichi-Sankyo, grants from Shionogi, other from PharmaEssentia, outside the submitted work. Kato N reports grants and other from Abbvie, grants and other from MSD K.K., grants and other from Chugai Pharmaceutical CO., LTD., grants and other from Mitsubishi Tanabe Pharma, grants and other from Gilead Sciences, grants and other from Bristol-Myers Squibb, outside the submitted work.
Open-Access: 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/
Corresponding author: Tatsuo Kanda, MD, PhD, Associate Professor, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Tokyo, Itabashi-ku 173-8610, Japan. kandat-cib@umin.ac.jp
Telephone: +81-3-39728111 Fax: +81-3-39568496
Received: September 13, 2018
Peer-review started: September 13, 2018
First decision: October 5, 2018
Revised: November 8, 2018
Accepted: November 15, 2018
Article in press: November 16, 2018
Published online: December 27, 2018
Processing time: 105 Days and 4.3 Hours
Abstract

The introduction of a direct-acting antiviral (DAA) for patients with hepatitis C virus (HCV) infection, could lead to higher sustained virologic response (SVR) rates with fewer adverse events, and it could shorten the treatment duration relative to the interferon era. Although most recent clinical studies have demonstrated that the occurrence rates of hepatocellular carcinoma (HCC) are decreased by SVR with both interferon-based and interferon-free-regimens, there are several reports about the unexpected observation of high rates of early tumor occurrence and recurrence in patients with HCV-related HCC undergoing interferon-free therapy despite SVR. Several mechanisms of HCC occurrence and rapid immunological changes, including cytokines and chemokines during and after DAA treatment, have also been reported. We focused on the possibilities that HCC occurs or recurs during and after DAA treatment, based on the reported clinical and basic studies. Further studies and observations will be needed to determine the short-term and long-term effects on hepatocarcinogenesis caused by the eradication of HCV with DAAs. New serum biomarkers and a follow-up system for HCV-patients with SVR should be established.

Keywords: Hepatitis C virus; Hepatocellular carcinoma; Sustained virologic response; Direct-acting antiviral agents

Core tip: The incidence of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) patients with sustained virologic response (SVR) after direct-acting antiviral (DAA) treatment is a serious health issue. We focused on the role of DAA treatment in hepatocarcinogenesis. DAAs may also lead to rapid changes in immune status through interactions between the host and HCV. Changes in the immune system may play a role in the progression of HCC. Further observations are needed to determine the effects on hepatocarcinogenesis caused by the eradication of HCV with DAAs.