The Risk of Hepatocellular Carcinoma After Directly Acting Antivirals for Hepatitis C Virus Treatment in Liver Transplanted Patients: Is It Real?
| Autor: | Costanza Maria Cristiani, Carlo Torti, Mario De Santis, Vincenzo Pisani, Alessio Strazzulla, Chiara Costa, Maria Concetta Postorino, Fabrizio Di Benedetto, Maria Mazzitelli, Rosa Maria Iemmolo, Ennio Carbone |
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| Přispěvatelé: | Strazzulla, A, Iemmolo, Rmr, Postorino, Mc, Mazzitelli, M, De Santis, M, Di Benedetto, F, Cristiani, Cm, Costa, C, Pisani, V, Torti, C, Carbone, E |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Simeprevir
medicine.medical_specialty Hepatitis C Virus Daclatasvir Directly acting antivirals Hepatitis C virus Hepatocellular carcinoma Interferon Liver transplant Case Report Liver Transplant medicine.disease_cause Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Directly Acting Antivirals Internal medicine medicine Hepatology business.industry Ribavirin Hepatocellular Carcinoma medicine.disease digestive system diseases Surgery Kowsar Infectious Diseases medicine.anatomical_structure chemistry 030220 oncology & carcinogenesis Abdomen 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Hepatitis Monthly |
| Popis: | Introduction Since directly acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) were introduced, conflicting data emerged about the risk of hepatocellular carcinoma (HCC) after interferon (IFN)-free treatments. We present a case of recurrent, extra-hepatic HCC in a liver-transplanted patient soon after successful treatment with DAAs, along with a short review of literature. Case presentation In 2010, a 53-year old man, affected by chronic HCV (genotype 1) infection and decompensated cirrhosis, underwent liver resection for HCC and subsequently received orthotopic liver transplantation. Then, HCV relapsed and, in 2013, he was treated with pegylated-IFN plus ribavirin; but response was null. In 2014, he was treated with daclatasvir plus simeprevir to reach sustained virological response. At baseline and at the end of HCV treatment, computed tomography (CT) scan of abdomen excluded any lesions suspected for HCC. However, alpha-fetoprotein was 2.9 ng/mL before DAAs, increasing up to 183.1 ng/mL at week-24 of follow-up after the completion of therapy. Therefore, CT scan of abdomen was performed again, showing two splenic HCC lesions. Conclusions Overall, nine studies have been published about the risk of HCC after DAAs. Patients with previous HCC should be carefully investigated to confirm complete HCC remission before starting, and proactive follow-up should be performed after DAA treatment. |
| Databáze: | OpenAIRE |
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