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. 2025 Feb 3;25(1):51.
doi: 10.1186/s12876-025-03611-w.

Liver cancer risk and changes in lifestyle habits after successful hepatitis C virus therapy post-DAA HCV therapy: lifestyle changes and liver cancer risk

Núria Granel #  1   2 , Gemma Iserte #  1   2   3 , Concepció Bartres  2 , Neus Llarch  1   2   3   4 , Anna Pla  2 , Víctor Sapena  1   2   5   6 , Zoe Mariño  2   3   4 , Sabela Lens  2   3   4 , Ramón Vilana  1   7   3   4 , Isabel Nuñez  7 , Anna Darnell  1   7   3   4 , Ernest Belmonte  1   7   3   4 , Ángeles García-Criado  1   7   3   4 , Alba Díaz  1   8   4 , Marco Sanduzzi-Zamparelli  1   2   3   4 , Carla Fuster  1   8   4 , Sergio Muñoz-Martínez  1   3   4 , Carmen Ayuso  1   7   3   4 , Jordi Rimola  1   7   3   4 , Alejandro Forner  1   2   3   4 , Alexandre Soler  1   7 , Ferran Torres  6 , José Ríos  5   6 , Jordi Bruix  1   2   3   4 , Andrew M Moon  9   10 , Xavier Forns  11   12   13 , María Reig  14   15   16   17
Affiliations

Liver cancer risk and changes in lifestyle habits after successful hepatitis C virus therapy post-DAA HCV therapy: lifestyle changes and liver cancer risk

Núria Granel et al. BMC Gastroenterol. .

Abstract

Background: The eradication of the Hepatitis C Virus (HCV) reduce the risk of liver cancer (LC), but lifestyle changes after cure may counterbalance its benefit. Our study investigates lifestyle changes that occur in HCV patients with Sustained Virological Response (SVR) after direct-acting antiviral (DAA) treatment.

Methods: In this prospective, single-center study, HCV patients with advanced liver disease (F3/F4) treated and cured with DAA were invited to fill a lifestyle habits questionnaire in and perform abdominal ultrasound (US), blood extraction and anthropometric measurements within the 1st month after SVR and every 6 months thereafter until 48 months of follow-up, LC development, death, or loss to follow-up.

Results: This prospective cohort included 182 patients with SVR after DAA in this first analysis through the 4 years of follow-up. At the time of SVR, 65.9% had cirrhosis, median BMI was 27.1 kg/m2, 74.2% were overweight or obese and 6.6% had an US with hepatic steatosis. Within a year of SVR, 9% of males and 4% of females progressed from normal weight to overweight/obesity and 19.4% increased alcohol consumption. At 48 months, there were statistically significant increases in BMI (0.75, p = 0.001) and alcohol consumption (6.4% p = 0.007).

Conclusions: In this prospective cohort, successful HCV therapy was followed by significant changes in lifestyle habits translating into increases in BMI and alcohol consumption. These post-SVR changes raise concerns that the chemopreventive benefits of HCV cure may be counterbalanced by increased risks of liver disease progression and LC development from metabolic risk factors and alcohol use. Post-SVR, patients may benefit from intensive counseling and pharmacotherapy to address obesity and alcohol use.

Trial registration/ clinical trial number: Not applicable.

Keywords: HCC; HCV; Lifestyle; Liver cancer; Nurse; SVR; Steatotic Liver diseases.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All participants signed the informed consent for the study previously approved by the Research Ethics Committee of the Hospital Clínic of Barcelona (HCB/2015/0752). Furthermore, the study was performed in accordance with the Declaration of Helsinki (Fortaleza, Brazil, October 2013). As specified in the informed consent form, data were collected from participants until revocation of it, death or completion 10 years after SVR. Consent for publication: No applicable. Competing interests: NG: received congress registration from Eisai; GI: received travel grants from Bayer; CB: none; NL: received consultancy fees from Bayer, Universal DX and AstraZeneca, speaker fees from Roche and AstraZeneca, travel funding from Bayer and congress registration from Eisai; AP: none; VS: received travel grants from Bayer and consultancy fees from LEO Pharma; SL: received consultancy and speaker fees from Gilead and Abbvie and grants from Gilead; ZM: received consultancy fees from Gilead, Abbvie, Alexion, Orphalan and Deep Genomics; speaker fees from Gilead, Abbvie and Orphalan. Research grants from Gilead; RV: none; IN: none; AD: received speaker fees and travel grants from Bayer; EB: none; AGC: received speaker fees from BTG and Terumo; AD: received speaker fees and travel grants from Bayer; MSZ: received speaker fees from Bayer and travel grants from Bayer, BTG, MSD-Eisai and Roche; CF: none; SMM: received speaker fees from Bayer and travel grants from Bayer, MDS and Eisai; CA: received speaker fees, travel and research grants from Bayer, BTG and Terumo; consultancy from Roche; LB: none; JR: has consulted for Roche and received speaker fees from Bayer and Roche and travel grants from Bayer; AS: none; AF: received lecture fees from Gilead, Boston Scientific, Roche, AstraZeneca and MSD; consultancy fees from AstraZeneca, Roche, SIRTEX, AB Exact Science, Taiho and Guerbert; FT: DSMB fees from Basiela Pharmaceutica International, ArchivelFarma, S.L, Daiichi-Sankyo Pharma Development, ArQule and Rovi; speaker fees from Bayer and educational and training fees from Janssen and Ferrer; JR: Novartis, Lilly, LETIPharma, Merck Sharp & Dohme de España, ViforFresenius, Astra Zeneca and Boehringer Ingelheim Boehringer Ingelheim lecture fees educational outside the submitted work; JB: has consulted for Arqule, Bayer-Shering Pharma, Novartis, BMS, BTG- Biocompatibles, Eisai, Kowa, Terumo, Gilead, Bio-Alliance, Roche, AbbVie, MSD, Sirtex, Ipsen, Astra-Medimmune, Incyte, Quirem, Adaptimmune, Lilly, Basilea, Nerviano, Sanofi; received research/educational grants from Bayer; paid conferences from Bayer, BTG, AstraZeneca and Ipsen; andlecture fees from Bayer-Shering Pharma, BTG-Biocompatibles, Eisai, Terumo, Sirtex and Ipsen; AMM: Consultant for TARGET RWE; XF: acted as advisor for Gilead; MR: has served as a consultant or on advisory boards and/or received travel support from Bayer, BMS, Roche, Ipsen, AstraZeneca, Eisai, Geneos Therapeutics, UniveralDx, MSD and Lilly, lecture fees from Bayer, BMS, Gilead, AstraZeneca, ROCHE and Lilly and Institutional research grants from Bayer and Ipsen.

Figures

Fig. 1
Fig. 1
Body Mass Index measurements in patients at baseline and during 48 months of follow-up. Body Mass Index at baseline and intra-patient differences from baseline during follow-up in females (light grey) and males (dark grey) with 95% confidence interval. Levels of significance: *p-value < 0.05; **p-value < 0.01; ***p-value < 0.001 (Student’s t-test)
Fig. 2
Fig. 2
Waist-hip ratio measurements in patients at baseline and during 48 months of follow-up. Waist-hip ratio at baseline and intra-patient differences from baseline during follow-up in females (light grey) and males (dark grey) with 95% confidence interval. Levels of significance: *p-value < 0.05; **p-value < 0.01; ***p-value < 0.001 (Student’s t-test)
Fig. 3
Fig. 3
Changes in patients’ alcohol consumption at baseline and during 48 months of follow-up. Alcohol consumption at baseline during the months of follow-up expressed in percentages with the categories of no answer (light grey), never (grey), a few times a month (dark grey), and a few times a week (black)
See this image and copyright information in PMC

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