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. 2021 Jul 22;13(15):3694.
doi: 10.3390/cancers13153694.

Five-Year Follow-Up of Cured HCV Patients under Real-World Interferon-Free Therapy

Robert Flisiak  1 , Dorota Zarębska-Michaluk  2 , Ewa Janczewska  3 , Tadeusz Łapiński  1 , Magdalena Rogalska  1 , Ewa Karpińska  4 , Tomasz Mikuła  5 , Beata Bolewska  6 , Jolanta Białkowska  7 , Katarzyna Flejscher-Stępniewska  8 , Krzysztof Tomasiewicz  9 , Kornelia Karwowska  10 , Monika Pazgan-Simon  11 , Anna Piekarska  12 , Hanna Berak  13 , Olga Tronina  14 , Aleksander Garlicki  15 , Jerzy Jaroszewicz  16
Affiliations

Five-Year Follow-Up of Cured HCV Patients under Real-World Interferon-Free Therapy

Robert Flisiak et al. Cancers (Basel). .

Abstract

(1) Background: Treatment of hepatitis C virus (HCV) infections with direct-acting antivirals (DAA) has demonstrated high efficacy and an excellent safety profile. The cured patients showed a sustained virological response and improved liver function, but also a continued risk of hepatocellular carcinoma (HCC) during the 2-3 years of follow-up after treatment; (2) Methods: A total of 192 patients out of 209 of the primary AMBER study were analyzed five years after treatment with ombitasvir/paritaprevir/ritonavir with or without dasabuvir and with or without ribavirin. Results: We confirmed that HCV clearance after DAA treatment is stable regardless of baseline liver fibrosis. We found that sustained virologic response is associated with a gradual but significant reduction in liver stiffness over 5 years. Liver function improved during the first 2 years of follow-up and remained stable thereafter. The risk of death due to HCC as well as death due to HCV persists through 5 years of follow-up after successful DAA treatment. However, in non-cirrhotic patients, it appears to clear up 3 years after treatment; (3) Conclusions: Monitoring for more than 5 years after curing HCV infection is necessary to assess the long-term risk of possible development of HCC, especially in patients with cirrhosis of the liver.

Keywords: hepatocellular carcinoma; liver cirrhosis; long-term follow-up; sustained virologic response; therapy; viral hepatitis C.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier plots of patients survival depending on presence of cirrhosis at the baseline.
Figure 2
Figure 2
Hepatocellular carcinoma diagnosed in particular years of the follow-up, with regards to patients survival (a) and presence of cirrhosis at the baseline (b).
Figure 3
Figure 3
Individual values (bars) and mean (dashed horizontal line) of the liver stiffness (kPa) measured at the baseline (before start of the treatment) and 5yFU (5 years following end of treatment) in patients with available paired data.
Figure 4
Figure 4
Changes in the liver stiffness between baseline and 5yFU in patients with available paired data.
See this image and copyright information in PMC

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