TY - JOUR
T1 - Chronic Hepatitis C Infection Treated with Direct-Acting Antiviral Agents and Occurrence/Recurrence of Hepatocellular Carcinoma
T2 - Does It Still Matter?
AU - Smirne, Carlo
AU - Crobu, Maria Grazia
AU - Landi, Irene
AU - Vercellino, Nicole
AU - Apostolo, Daria
AU - Pinato, David James
AU - Vincenzi, Federica
AU - Minisini, Rosalba
AU - Tonello, Stelvio
AU - D’Onghia, Davide
AU - Ottobrelli, Antonio
AU - Martini, Silvia
AU - Bracco, Christian
AU - Fenoglio, Luigi Maria
AU - Campanini, Mauro
AU - Berton, Alessandro Maria
AU - Ciancio, Alessia
AU - Pirisi, Mario
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/12
Y1 - 2024/12
N2 - Hepatitis C virus (HCV) infection is a significant risk factor for liver cirrhosis and hepatocellular carcinoma (HCC). Traditionally, the primary prevention strategy for HCV-associated HCC has focused on removing infection through antiviral regimes. Currently, highly effective direct-acting antivirals (DAAs) offer extraordinary success across all patient categories, including cirrhotics. Despite these advancements, recent studies have reported that even after sustained virologic response (SVR), individuals with advanced liver disease/cirrhosis at the time of DAA treatment may still face risks of HCC occurrence or recurrence. Based on this premise, this review tries to shed light on the multiple mechanisms that establish a tumorigenic environment, first, during chronic HCV infection and then, after eventual viral eradication by DAAs. Furthermore, it reviews evidence reported by recent observational studies stating that the use of DAAs is not associated with an increased risk of HCC development but rather, with a significantly lower chance of liver cancer compared with DAA-untreated patients. In addition, it seeks to provide some practical guidance for clinicians, helping them to manage HCC surveillance of patients who have achieved SVR with DAAs.
AB - Hepatitis C virus (HCV) infection is a significant risk factor for liver cirrhosis and hepatocellular carcinoma (HCC). Traditionally, the primary prevention strategy for HCV-associated HCC has focused on removing infection through antiviral regimes. Currently, highly effective direct-acting antivirals (DAAs) offer extraordinary success across all patient categories, including cirrhotics. Despite these advancements, recent studies have reported that even after sustained virologic response (SVR), individuals with advanced liver disease/cirrhosis at the time of DAA treatment may still face risks of HCC occurrence or recurrence. Based on this premise, this review tries to shed light on the multiple mechanisms that establish a tumorigenic environment, first, during chronic HCV infection and then, after eventual viral eradication by DAAs. Furthermore, it reviews evidence reported by recent observational studies stating that the use of DAAs is not associated with an increased risk of HCC development but rather, with a significantly lower chance of liver cancer compared with DAA-untreated patients. In addition, it seeks to provide some practical guidance for clinicians, helping them to manage HCC surveillance of patients who have achieved SVR with DAAs.
KW - advanced fibrosis
KW - cirrhosis
KW - direct-acting antiviral agents
KW - hepatitis C virus
KW - hepatocellular carcinoma
KW - interferon
KW - liver carcinogenesis
KW - occurrence
KW - recurrence
KW - sustained virological response
UR - http://www.scopus.com/inward/record.url?scp=85213209691&partnerID=8YFLogxK
U2 - 10.3390/v16121899
DO - 10.3390/v16121899
M3 - Review article
SN - 1999-4915
VL - 16
JO - Viruses
JF - Viruses
IS - 12
M1 - 1899
ER -