Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals
By pegylated interferon (PegIFN)-free direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection, a sustained virological response (SVR) rate >95% can be attained with a satisfactory tolerability and shorter treatment duration. However, it remains controversial whether there is any...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/11/3414 |
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| author | Hye Won Lee Dai Hoon Han Hye Jung Shin Jae Seung Lee Seung Up Kim Jun Yong Park Do Young Kim Sang Hoon Ahn Beom Kyung Kim |
| author_facet | Hye Won Lee Dai Hoon Han Hye Jung Shin Jae Seung Lee Seung Up Kim Jun Yong Park Do Young Kim Sang Hoon Ahn Beom Kyung Kim |
| author_sort | Hye Won Lee |
| collection | DOAJ |
| description | By pegylated interferon (PegIFN)-free direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection, a sustained virological response (SVR) rate >95% can be attained with a satisfactory tolerability and shorter treatment duration. However, it remains controversial whether there is any difference in prognosis depending on regimens—PegIFN or DAAs. We compared the probabilities of hepatocellular carcinoma (HCC) development between patients achieving an SVR by PegIFN/ribavirin (PegIFN group, n = 603) and DAAs (DAAs group, n = 479). The DAAs group was significantly older and had a higher proportion of cirrhosis than the PegIFN group. Before adjustment, the DAAs group had a higher HCC incidence than the PegIFN group (<i>p</i> < 0.001). However, by multivariate analyses, the DAAs (vs. PegIFN) group was not associated with HCC risk (adjusted hazard ratio 0.968, 95% confidence interval 0.380–2.468; <i>p</i> = 0.946). Old age, male, higher body mass index, cirrhosis, and lower platelet count were associated with increased HCC risk (all <i>p</i> < 0.05). After propensity score matching (PSM), a similar HCC risk between the two groups was observed (<i>p</i> = 0.372). We also compared HCC incidences according to sofosbuvir (SOF)-based and SOF-free DAAs, showing a similar risk in both groups before adjustment (<i>p</i> = 0.478) and after PSM (<i>p</i> = 0.855). In conclusion, post-SVR HCC risks were comparable according to treatment regimens; PegIFN- vs. DAA-based regimens and SOF-based vs. SOF-free DAA regimens. Further studies with a longer follow-up period are required. |
| first_indexed | 2024-03-10T14:45:47Z |
| format | Article |
| id | doaj.art-5b412cf05ece4485aa8678db3cd395ac |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T14:45:47Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5b412cf05ece4485aa8678db3cd395ac2023-11-20T21:21:42ZengMDPI AGCancers2072-66942020-11-011211341410.3390/cancers12113414Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting AntiviralsHye Won Lee0Dai Hoon Han1Hye Jung Shin2Jae Seung Lee3Seung Up Kim4Jun Yong Park5Do Young Kim6Sang Hoon Ahn7Beom Kyung Kim8Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaYonsei Liver Center, Severance Hospital, Seoul 03722, KoreaBiostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, KoreaBy pegylated interferon (PegIFN)-free direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection, a sustained virological response (SVR) rate >95% can be attained with a satisfactory tolerability and shorter treatment duration. However, it remains controversial whether there is any difference in prognosis depending on regimens—PegIFN or DAAs. We compared the probabilities of hepatocellular carcinoma (HCC) development between patients achieving an SVR by PegIFN/ribavirin (PegIFN group, n = 603) and DAAs (DAAs group, n = 479). The DAAs group was significantly older and had a higher proportion of cirrhosis than the PegIFN group. Before adjustment, the DAAs group had a higher HCC incidence than the PegIFN group (<i>p</i> < 0.001). However, by multivariate analyses, the DAAs (vs. PegIFN) group was not associated with HCC risk (adjusted hazard ratio 0.968, 95% confidence interval 0.380–2.468; <i>p</i> = 0.946). Old age, male, higher body mass index, cirrhosis, and lower platelet count were associated with increased HCC risk (all <i>p</i> < 0.05). After propensity score matching (PSM), a similar HCC risk between the two groups was observed (<i>p</i> = 0.372). We also compared HCC incidences according to sofosbuvir (SOF)-based and SOF-free DAAs, showing a similar risk in both groups before adjustment (<i>p</i> = 0.478) and after PSM (<i>p</i> = 0.855). In conclusion, post-SVR HCC risks were comparable according to treatment regimens; PegIFN- vs. DAA-based regimens and SOF-based vs. SOF-free DAA regimens. Further studies with a longer follow-up period are required.https://www.mdpi.com/2072-6694/12/11/3414interferondirect-acting antiviralshepatocellular carcinomaprognosiscomparison |
| spellingShingle | Hye Won Lee Dai Hoon Han Hye Jung Shin Jae Seung Lee Seung Up Kim Jun Yong Park Do Young Kim Sang Hoon Ahn Beom Kyung Kim Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals Cancers interferon direct-acting antivirals hepatocellular carcinoma prognosis comparison |
| title | Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals |
| title_full | Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals |
| title_fullStr | Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals |
| title_full_unstemmed | Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals |
| title_short | Hepatocellular Carcinoma Risk According to Regimens for Eradication of Hepatitis C Virus; Interferon or Direct Acting Antivirals |
| title_sort | hepatocellular carcinoma risk according to regimens for eradication of hepatitis c virus interferon or direct acting antivirals |
| topic | interferon direct-acting antivirals hepatocellular carcinoma prognosis comparison |
| url | https://www.mdpi.com/2072-6694/12/11/3414 |
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