Direct-acting antiviral therapy for patients with hepatitis C virus-related hepatocellular carcinoma: A nationwide cohort study.
Journal
Clinical and molecular hepatology
Journal Volume
31
Journal Issue
3
Start Page
899
End Page
913
ISSN
2287-285X
Date Issued
2025-07
Author(s)
Lee, Shou-Wu
Yang, Sheng-Shun
Tsai, Pei-Chien
Huang, Chung-Feng
Chen, Chi-Yi
Hung, Chao-Hung
Tai, Chi-Ming
Cheng, Pin-Nan
Kuo, Hsing-Tao
Tseng, Kuo-Chih
Mo, Lein-Ray
Lo, Ching-Chu
Huang, Yi-Hsiang
Lin, Han-Chieh
Lee, Pei-Lun
Bair, Ming-Jong
Chang, Te-Sheng
Lin, Chun-Yen
Wang, Szu-Jen
Hsieh, Tsai-Yuan
Yang, Tzeng-Hue
Peng, Cheng-Yuan
Yang, Chi-Chieh
Chong, Lee-Won
Huang, Chien-Wei
Lin, Chih-Wen
Chu, Cheng-Hsin
Tsai, Ming-Chang
Chuang, Wan-Long
Lee, Teng-Yu
Yu, Ming-Lung
Abstract
Background/Aims: The survival benefit of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection in patients with hepatocellular carcinoma (HCC), particularly in Barcelona Clinic Liver Cancer (BCLC) stages B/C, remains largely uncertain. We aimed to explore the impact of DAA therapy on overall survival (OS) in HCC patients using a nationwide cohort study. Methods: We utilized the nationwide Taiwan Association for the Study of the Liver (TASL) HCV Registry (TACR) database to include all adults receiving a DAA therapy for HCV, excluding those with other viral infections, liver transplantation, non-HCC malignancies, and terminal-staged HCC. We respectively analyzed the adjusted odds ratio (aOR) for sustained virological response (SVR) and adjusted hazard ratio (aHR) for OS. Results: Between December 2013 and December 2020, 2,205 (9.3%) patients with HCC and 21,569 (90.7%) patients without HCC were include. The SVR rates were 96.6% in the HCC group and 98.8% in the non-HCC group (P<0.001), with HCC being an independent risk factor affecting SVR (aOR 0.41; 95% CI 0.31–0.54; P<0.001). In the whole patient cohort, SVR was independently associated with improved OS (aHR 0.46; 95% CI 0.35–0.60; P<0.001). Among patients with baseline HCC, SVR remained an independent factor related to OS (aHR 0.41; 95% CI 0.28–0.59; P<0.001). The impact of SVR on OS persisted significantly across BCLC stages 0/A and stages B/C. Conclusions: High SVR rates among HCC patients underscore the importance of DAA therapy in enhancing OS, reaffirming its efficacy across various HCC stages.
Subjects
Antivirals
Chronic hepatitis C
Liver cancer
Survival
Sustained virological response
SDGs
Type
journal article