With the introduction of direct-acting antiviral agents (DAA), the rate of sustained virological response (SVR) in the treatment of hepatitis C virus (HCV) has radically improved to over 95%. Robust scientific evidence supports a beneficial role of SVR after interferon therapy in the progression of cirrhosis, resulting in a decreased incidence of hepatocellular carcinoma (HCC). However, a debate on the impact of DAAs on the development of HCC is ongoing. This review aimed to analyse the scientific literature regarding the risk of HCC in terms of its recurrence and occurrence after the use of DAAs to eradicate HCV infection. Among 11 studies examining HCC occurrence, the de novo incidence rate ranged from 0 to 7.4% (maximum follow-up: 18 mo). Among 18 studies regarding HCC recurrence, the rate ranged from 0 to 54.4% (maximum "not well-defined" followup: 32 mo). This review highlights the major difficulties in interpreting data and reconciling the results of the included studies. These difficulties include heterogeneous cohorts, potential misclassifications of HCC prior to DAA therapy, the absence of an adequate control group, short follow-up times and different kinds of follow-up. Moreover, no clinical feature-based scoring system accounts for the molecular characteristics and pathobiology of the tumours. Nonetheless, this review does not suggest that there is a higher rate of de novo HCC occurrence or recurrence after DAA therapy in patients with previous HCV infection.

Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows / Guarino, Maria; Sessa, Anna; Cossiga, Valentina; Morando, Federica; Caporaso, Nicola; Morisco, Filomena; Luca, Viganó; Romana, Ponziani Francesca; Maurizio, Pompili; Cillo, Umberto; Burra, Patrizia; Mescoli, Claudia; Gambato, Martina; Paolo, Russo Francesco; Alessandro, Vitale; Giuseppe, Cabibbo; Mauro, Vigano'; Giovanni, Galati; Villa, Erica; Lupo, Luigi G.; Maria, Rendina; Losito, Francesco; Fucilli, Fabio; Persico, Marcello; D'Ambrosio, Roberta; Sangiovanni, Angelo; Massimo, Iavarone; Giuseppina, Brancaccio; Cucchetti, Alessandro; Renzulli, Matteo; Franco, Trevisani; Miele, Luca; Grieco, Antonio; Rapaccini, Gianlodovico; Gasbarrini, Antonio; Sandri, Giovanni Battisa Levi; Melandro, Fabio; Rossi, Massimo; Quirino, Lai; Lenci, Ilaria; Manzia, Tommaso Maria; Tortora, Raffaella; Di Costanzo, Giovan Giuseppe; Ghinolfi, Davide; Rreka, Erion; Carrai, Paola; Simonetti, Natalia; Rodolfo, Sacco; Sposito, Carlo; Bhoori, Sherrie; Di Sandro, Stefano; Foschi, Francesco Giuseppe; Gardini, Andrea Casadei; Nicolini, Daniele; Mazzocato, Susanna; Alba, Kostandini; Violi, Paola; Baccarani, Umberto; Pravisani, Riccardo; Vincenzi, Valter. - In: WORLD JOURNAL OF GASTROENTEROLOGY. - ISSN 1007-9327. - 24:(2018), pp. 2582-2595. [10.3748/wjg.v24.i24.2582]

Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows

Erica, Villa;Rossi, Massimo;Di Sandro, Stefano;Gardini, Andrea Casadei;
2018

Abstract

With the introduction of direct-acting antiviral agents (DAA), the rate of sustained virological response (SVR) in the treatment of hepatitis C virus (HCV) has radically improved to over 95%. Robust scientific evidence supports a beneficial role of SVR after interferon therapy in the progression of cirrhosis, resulting in a decreased incidence of hepatocellular carcinoma (HCC). However, a debate on the impact of DAAs on the development of HCC is ongoing. This review aimed to analyse the scientific literature regarding the risk of HCC in terms of its recurrence and occurrence after the use of DAAs to eradicate HCV infection. Among 11 studies examining HCC occurrence, the de novo incidence rate ranged from 0 to 7.4% (maximum follow-up: 18 mo). Among 18 studies regarding HCC recurrence, the rate ranged from 0 to 54.4% (maximum "not well-defined" followup: 32 mo). This review highlights the major difficulties in interpreting data and reconciling the results of the included studies. These difficulties include heterogeneous cohorts, potential misclassifications of HCC prior to DAA therapy, the absence of an adequate control group, short follow-up times and different kinds of follow-up. Moreover, no clinical feature-based scoring system accounts for the molecular characteristics and pathobiology of the tumours. Nonetheless, this review does not suggest that there is a higher rate of de novo HCC occurrence or recurrence after DAA therapy in patients with previous HCV infection.
24
2582
2595
Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows / Guarino, Maria; Sessa, Anna; Cossiga, Valentina; Morando, Federica; Caporaso, Nicola; Morisco, Filomena; Luca, Viganó; Romana, Ponziani Francesca; Maurizio, Pompili; Cillo, Umberto; Burra, Patrizia; Mescoli, Claudia; Gambato, Martina; Paolo, Russo Francesco; Alessandro, Vitale; Giuseppe, Cabibbo; Mauro, Vigano'; Giovanni, Galati; Villa, Erica; Lupo, Luigi G.; Maria, Rendina; Losito, Francesco; Fucilli, Fabio; Persico, Marcello; D'Ambrosio, Roberta; Sangiovanni, Angelo; Massimo, Iavarone; Giuseppina, Brancaccio; Cucchetti, Alessandro; Renzulli, Matteo; Franco, Trevisani; Miele, Luca; Grieco, Antonio; Rapaccini, Gianlodovico; Gasbarrini, Antonio; Sandri, Giovanni Battisa Levi; Melandro, Fabio; Rossi, Massimo; Quirino, Lai; Lenci, Ilaria; Manzia, Tommaso Maria; Tortora, Raffaella; Di Costanzo, Giovan Giuseppe; Ghinolfi, Davide; Rreka, Erion; Carrai, Paola; Simonetti, Natalia; Rodolfo, Sacco; Sposito, Carlo; Bhoori, Sherrie; Di Sandro, Stefano; Foschi, Francesco Giuseppe; Gardini, Andrea Casadei; Nicolini, Daniele; Mazzocato, Susanna; Alba, Kostandini; Violi, Paola; Baccarani, Umberto; Pravisani, Riccardo; Vincenzi, Valter. - In: WORLD JOURNAL OF GASTROENTEROLOGY. - ISSN 1007-9327. - 24:(2018), pp. 2582-2595. [10.3748/wjg.v24.i24.2582]
Guarino, Maria; Sessa, Anna; Cossiga, Valentina; Morando, Federica; Caporaso, Nicola; Morisco, Filomena; Luca, Viganó; Romana, Ponziani Francesca; Maurizio, Pompili; Cillo, Umberto; Burra, Patrizia; Mescoli, Claudia; Gambato, Martina; Paolo, Russo Francesco; Alessandro, Vitale; Giuseppe, Cabibbo; Mauro, Vigano'; Giovanni, Galati; Villa, Erica; Lupo, Luigi G.; Maria, Rendina; Losito, Francesco; Fucilli, Fabio; Persico, Marcello; D'Ambrosio, Roberta; Sangiovanni, Angelo; Massimo, Iavarone; Giuseppina, Brancaccio; Cucchetti, Alessandro; Renzulli, Matteo; Franco, Trevisani; Miele, Luca; Grieco, Antonio; Rapaccini, Gianlodovico; Gasbarrini, Antonio; Sandri, Giovanni Battisa Levi; Melandro, Fabio; Rossi, Massimo; Quirino, Lai; Lenci, Ilaria; Manzia, Tommaso Maria; Tortora, Raffaella; Di Costanzo, Giovan Giuseppe; Ghinolfi, Davide; Rreka, Erion; Carrai, Paola; Simonetti, Natalia; Rodolfo, Sacco; Sposito, Carlo; Bhoori, Sherrie; Di Sandro, Stefano; Foschi, Francesco Giuseppe; Gardini, Andrea Casadei; Nicolini, Daniele; Mazzocato, Susanna; Alba, Kostandini; Violi, Paola; Baccarani, Umberto; Pravisani, Riccardo; Vincenzi, Valter
File in questo prodotto:
File Dimensione Formato  
WJG-24-2582.pdf

accesso aperto

Tipologia: Post-print dell'autore (bozza post referaggio)
Dimensione 1.5 MB
Formato Adobe PDF
1.5 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/1177638
Citazioni
  • ???jsp.display-item.citation.pmc??? 26
  • Scopus 42
  • ???jsp.display-item.citation.isi??? 43
social impact