The risk of early occurrence and recurrence of hepatocellular carcinoma in hepatitis C-infected patients treated with direct-acting antivirals with and without pegylated interferon: A Belgian experience.

Autor: Bielen R; Faculty of Medicine and Life sciences, Hasselt University, Hasselt, Belgium.; Department of Gastro-Enterology and Hepatology, Ziekenhuis-Oost Limburg, Genk, Belgium., Moreno C; Department of Gastro-Enterology and Hepatopancreatology, Erasme Hospital, Brussels, Belgium., Van Vlierberghe H; Department of Hepatology and Gastro-Enterology, University Hospitals Gent, Gent, Belgium., Bourgeois S; Department of Gastro-Enterology and Hepatology, ZNA Stuivenberg, Antwerp, Belgium., Mulkay JP; Department of Gastro-Enterology and Hepatology, Hôpital Saint-Pierre, Brussels, Belgium., Vanwolleghem T; Department of Gastro-Enterology and Hepatology, Antwerp University Hospital, Edegem, Belgium., Verlinden W; Department of Gastro-Enterology and Hepatology, Antwerp University Hospital, Edegem, Belgium., Brixco C; Department of Gastroenterology and Digestive Oncology, CHR Citadelle, Liège, Belgium., Decaestecker J; Department of Gastro-Enterology and Hepatology, AZ Delta, Roeselare, Belgium.; Department of Gastro-Enterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium., de Galocsy C; Department of Gastro-Enterology and Hepatology, Hôpital HIS Bracops, Anderlecht, Brussels, Belgium., Janssens F; Department of Gastro-Enterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium.; Department of Gastro-Enterology and Hepatology, Jessa Hospital, Hasselt, Belgium., Van Overbeke L; Department of Gastro-Enterology and Hepatology, AZ Sint Maarten, Mechelen, Belgium., Van Steenkiste C; Department of Hepatology and Gastro-Enterology, University Hospitals Gent, Gent, Belgium.; Department of Gastro-Enterology and Hepatology, AZ Maria Middelares, Gent, Belgium., D'Heygere F; Department of Gastro-Enterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium.; Department of Gastro-Enterology and Hepatology, AZ Groeninge, Kortrijk, Belgium., Cool M; Department of Gastro-Enterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium.; Department of Gastro-Enterology and Hepatology, AZ Damiaan, Oostende, Belgium., Wuyckens K; Faculty of Medicine and Life sciences, Hasselt University, Hasselt, Belgium.; Department of Gastro-Enterology and Hepatology, Ziekenhuis-Oost Limburg, Genk, Belgium., Nevens F; Department of Gastro-Enterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium., Robaeys G; Faculty of Medicine and Life sciences, Hasselt University, Hasselt, Belgium.; Department of Gastro-Enterology and Hepatology, Ziekenhuis-Oost Limburg, Genk, Belgium.; Department of Gastro-Enterology and Hepatology, University Hospitals KULeuven, Leuven, Belgium.
Jazyk: angličtina
Zdroj: Journal of viral hepatitis [J Viral Hepat] 2017 Nov; Vol. 24 (11), pp. 976-981. Date of Electronic Publication: 2017 Aug 03.
DOI: 10.1111/jvh.12726
Abstrakt: Recently, concerns were raised of high rates of HCC recurrence in patients treated with direct-acting antivirals (DAA) for hepatitis C infection. We investigated the HCC occurrence and recurrence rates within 6 months after treatment with DAA with or without pegylated interferon (PEG-IFN) in real life. This is a retrospective, multicenter cohort trial, executed in 15 hospitals distributed across Belgium. Populations were matched based on fibrosis score (Metavir F3-F4). Patients with a Child-Pugh score ≥ B were excluded. In total, 567 patients were included, of whom 77 were treated with PEG-IFN+DAA between 2008 and 2013 and 490 with DAA without PEG-IFN between 2013 and 2015. Patients treated with PEG-IFN+DAA (53±9y) were younger than patients treated with DAA without PEG-IFN (59±12y) (P=.001). 47% of patients treated with PEG-IFN+DAA were in the F4 stage vs 67% of patients treated with DAA without PEG-IFN (P=.001). Screening was inadequate in 20% of both patient groups (P=.664). The early occurrence rate of HCC was 1.7% and 1.1% in patients treated with DAA with and without PEG-IFN, respectively (P=.540). The early recurrence rate was 0% in patients treated with PEG-IFN+DAA and 15.0% in patients treated with DAA without PEG-IFN (P=.857). There is no difference in early occurrence of new HCC between patients treated with DAA with and without PEG-IFN. We did observe a high early recurrence rate of HCC in patients treated with DAA without PEG-IFN. However, these patients were at baseline more at risk for HCC. Finally, in 20%, screening for HCC was inadequate.
(© 2017 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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