Direct-acting antiviral therapy prolongs survival in HCV-infected HCC patients

Use of direct-acting antivirals (DAAs) to treat hepatitis C virus (HCV) in hepatocellular carcinoma (HCC) patients with documented response to therapy appears to yield a significant reduction in mortality, as shown in a recent study.

The retrospective study included 797 patients with HCV-related HCC, among whom 383 (48.1 percent) received DAA therapy. All patients achieved a complete response to resection, local ablation, transarterial chemo- or radioembolization, or radiation therapy.

There were 43 deaths that occurred during 941 person-years of follow-up in the DAA group in comparison with 103 deaths during 526.6 person-years of follow-up in the nontreated group (crude rate ratio, 0.23, 95 percent CI, 0.16–0.33).

Inverse probability-weighted analyses revealed DAA therapy to be associated with a significant decrease in the risk of death (hazard ratio [HR], 0.54, 95 percent CI, 0.33–0.90). This protective association differed by sustained virologic response (SVR) to DAA therapy, such that mortality risk was reduced in patients who achieved SVR (HR, 0.29, 0.18–0.47) but not in those without SVR (HR, 1.13, 0.55–2.33).

Median time from HCC complete response to DAA initiation was 7.7 months, with 20.2 percent of participants treated within 3 months, 21.5 percent between 3 and 6 months, 25.5 percent between 6 and 12 months, and 32.9 percent >12 months after HCC complete response. A total of 79.4 percent of DAA-treated patients achieved SVR, while 11.5 percent had treatment-failure and 9.1 percent had no documented assessment of SVR.

The present data suggest that HCV-infected patients with a history of HCC may benefit from DAA therapies, according to researchers.