Hepatitis C Virus Elimination Using Direct Acting Antivirals after the Radical Cure of Hepatocellular Carcinoma Suppresses the Recurrence of the Cancer

Abstract

It remains unclear whether hepatocellular carcinoma (HCC) recurrence in hepatitis C virus (HCV)-infected patients can be suppressed by the elimination of the virus using direct-acting antivirals (DAAs) after radical HCC treatment. We evaluated the sustained inhibitory effect of DAAs on HCC recurrence after curative treatment. This multicenter retrospective study included 190 HCV-positive patients after radical treatment for early-stage HCC. Patients were classified into the DAA treatment group (n = 70) and the non-DAA treatment group (n = 120) after HCC treatment. After propensity score matching (PSM), 112 patients were assessed for first and second recurrences using the Kaplan-Meier method and analyzed using a log-rank test. The first recurrence rates at 1 and 3 years were 3.6% and 42.1% in the DAA treatment group and 21.7% and 61.9% in the non-DAA treatment group, respectively (p = 0.0026). Among 85 patients who received radical treatment, the second recurrence rate at 3 years was 2.2% in the DAA treatment group and 33.9% in the non-DAA treatment group (p = 0.0128). In HCV-positive patients with early-stage HCC, the first and second recurrences were suppressed by DAA therapy after radical treatment, suggesting that the inhibitory effect of DAA therapy on HCC recurrence was sustained.

Keywords: direct-acting antiviral; hepatic resection; hepatitis C virus; hepatocellular carcinoma; propensity score matching; radiofrequency ablation; recurrence.

Figure 1

Recurrence rate after propensity score matching (PSM) analysis. (a) Overall recurrence rate of patients after curative treatment for HCC. (b) Recurrence rates of patients with and without DAA treatment following HCC curative treatment. Solid line represents DAA therapy group; dotted line represents non-DAA-treated group.

Figure 2

Second recurrence rate after propensity score matching (PSM) analysis. (a) Overall second recurrence rate of 85 patients with curative treatment for initial and first recurrent HCC. (b) Second recurrence rates of 85 patients with curative treatment for initial and first recurrent HCC. Solid line represents DAA therapy group; dotted line represents non-DAA-treated group.