Hepatitis C virus cure rates are reduced in patients with active but not inactive hepatocellular carcinoma: A practice implication
Journal
Clinical Infectious Diseases
Journal Volume
71
Journal Issue
11
Pages
2840-2848
Date Issued
2020
Author(s)
Ogawa E.
Toyoda H.
Iio E.
Jun D.W.
Huang C.-F.
Enomoto M.
Hsu Y.-C.
Haga H.
Iwane S.
Wong G.
Lee D.H.
Tada T.
Chuang W.-L.
Hayashi J.
Cheung R.
Yasuda S.
Tseng C.-H.
Takahashi H.
Tran S.
Yeo Y.H.
Henry L.
Barnett S.D.
Nomura H.
Nakamuta M.
Dai C.-Y.
Huang J.-F.
Yang H.-I.
Lee M.-H.
Jun M.J.
Eguchi Y.
Ueno Y.
Tamori A.
Furusyo N.
Yu M.-L.
Tanaka Y.
Nguyen M.H.
Ahn S.B.
Azuma K.
Dohmen K.
Jeong J.Y.
Jung J.H.
Kajiwara E.
Kato M.
Kawano A.
Koyanagi T.
Ooho A.
Park S.H.
Satoh T.
Shimoda S.
Song D.S.
Takahashi K.
Yeh M.-L.
Yoon E.L.
Real-World Evidence from the Asia Liver Consortium Investigators
Abstract
BACKGROUND: Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCC patients. METHODS: Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCC patients. RESULTS: We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = .03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC. CONCLUSIONS: Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCC patients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCC patients.
SDGs
Publisher
Oxford University Press
Type
journal article