Effect of Direct Acting Antiviral Drugs on the Occurrence and Recurrence of Intra- and Extra-Hepatic Malignancies in Patients with Chronic Hepatitis C Virus Infection
The use of direct-acting antivirals (DAAs) has drastically changed the management of HCV-infected patients by achieving a 95-98% sustained virologic response (SVR) and reducing morbidity and mortality in this population. However, despite their effectiveness, controversy exists concerning the occurre...
Gespeichert in:
| Veröffentlicht in: | Cancers 2024-07, Vol.16 (14), p.2573 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 14 |
| container_start_page | 2573 |
| container_title | Cancers |
| container_volume | 16 |
| creator | Radu, Pompilia Becchetti, Chiara Schropp, Jonas Schmid, Patrick Künzler-Heule, Patrizia Mertens, Joachim Moradpour, Darius Müllaupt, Beat Semela, David Negro, Francesco Heim, Markus Clerc, Olivier Roelens, Maroussia Keiser, Olivia Berzigotti, Annalisa Swiss Hepatitis C Cohort Study |
| description | The use of direct-acting antivirals (DAAs) has drastically changed the management of HCV-infected patients by achieving a 95-98% sustained virologic response (SVR) and reducing morbidity and mortality in this population. However, despite their effectiveness, controversy exists concerning the occurrence of oncologic events following DAA therapy.
A retrospective analysis was conducted on data from the Swiss Hepatitis C Cohort Study, a prospective cohort involving patients with positive HCV viremia upon inclusion, enrolled in various Swiss centers from September 2000 to November 2021. To examine potential differences in the risk of intrahepatic tumor (IHT) occurrence and death among patients treated with direct-acting antivirals (DAAs), untreated patients, and those receiving interferon (IFN)-based therapy, a semiparametric competing risk proportional hazards regression model was used.
Among 4082 patients (63.1% male, median age 45 years; genotype 1: 54.1%; cirrhosis: 16.1%), 1026 received exclusive treatment with IFN-based regimens, and 1180 were treated solely with DAAs. Over a median follow-up of 7.8 years (range: 3.8-11.9), 179 patients (4.4%) developed intrahepatic tumors (IHT), and 168 (4.1%) experienced extrahepatic tumors (EHT). The 5-year cumulative incidence of IHT was 1.55% (95% CI 0.96-2.48) for IFN-based therapy, 4.27% (95% CI 2.93-6.2) for DAA and 0.89% (95% CI 0.4-1.99) for untreated patients. There was no statistically significant difference in the risk of developing IHT (HR = 1.34; 95% CI = [0.70; 2.58];
= 0.380) or death (HR = 0.66; 95% CI = [0.43; 1.03];
= 0.066) between patients treated with DAAs and those treated with IFN.
The DAAs reduced the risk of death and were not associated with an increased risk of extrahepatic tumors (EHT). In the adjusted model, accounting for cirrhosis and high liver stiffness, the DAA treatment was associated with a higher risk of IHT occurrence compared with untreated patients, emphasizing the relevance of implementing standardized hepatocellular carcinoma (HCC) screening post-DAA treatment. |
| doi_str_mv | 10.3390/cancers16142573 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_3085114761</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A803764010</galeid><sourcerecordid>A803764010</sourcerecordid><originalsourceid>FETCH-LOGICAL-c387t-1d620d157f7465b642ec34d3c300449adb9bb56b99a41e48925c5afda1c292aa3</originalsourceid><addsrcrecordid>eNptks1vFCEYxomxsU3t2Zsh8eJlWr4GZo6b7Wqb1LRp1OuEYV52aWZhBcaPf8i_U8atVZvCgRf4PQ9PyIvQK0pOOW_JmdHeQExUUsFqxZ-hI0YUq6RsxfN_6kN0ktIdKYNzqqR6gQ6LWlJG2RH6ubIWTMbB4nMX52phsvNrvPDZfXVRj_g8TuuEg8d5A_jamClGKA9j7Qd8Cw_b4nDpc9TV74vV97m8gJ3OzuAPenRrX-I6SNh5fFNOweeEv7m8wctNDL5Qezq7hJf4s4tTKoZzOBf8S3Rg9Zjg5H49Rp_erT4uL6qr6_eXy8VVZXijckUHychAa2WVkHUvBQPDxcANJ0SIVg992_e17NtWCwqiaVltam0HTQ1rmdb8GL3d--5i-DJByt3WJQPjqD2EKXWcNDWlQkla0DeP0LswRV_SzZRQrKGk-Uut9Qid8zaUfzGzabdoCFdSEEoKdfoEVeYAW2eCB-vK-X-Cs73AxJBSBNvtotvq-KOjpJubo3vUHEXx-j7u1G9heOD_tAL_BRq7tSM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3084728108</pqid></control><display><type>article</type><title>Effect of Direct Acting Antiviral Drugs on the Occurrence and Recurrence of Intra- and Extra-Hepatic Malignancies in Patients with Chronic Hepatitis C Virus Infection</title><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Radu, Pompilia ; Becchetti, Chiara ; Schropp, Jonas ; Schmid, Patrick ; Künzler-Heule, Patrizia ; Mertens, Joachim ; Moradpour, Darius ; Müllaupt, Beat ; Semela, David ; Negro, Francesco ; Heim, Markus ; Clerc, Olivier ; Roelens, Maroussia ; Keiser, Olivia ; Berzigotti, Annalisa ; Swiss Hepatitis C Cohort Study</creator><creatorcontrib>Radu, Pompilia ; Becchetti, Chiara ; Schropp, Jonas ; Schmid, Patrick ; Künzler-Heule, Patrizia ; Mertens, Joachim ; Moradpour, Darius ; Müllaupt, Beat ; Semela, David ; Negro, Francesco ; Heim, Markus ; Clerc, Olivier ; Roelens, Maroussia ; Keiser, Olivia ; Berzigotti, Annalisa ; Swiss Hepatitis C Cohort Study ; Swiss Hepatitis C Cohort Study</creatorcontrib><description>The use of direct-acting antivirals (DAAs) has drastically changed the management of HCV-infected patients by achieving a 95-98% sustained virologic response (SVR) and reducing morbidity and mortality in this population. However, despite their effectiveness, controversy exists concerning the occurrence of oncologic events following DAA therapy.
A retrospective analysis was conducted on data from the Swiss Hepatitis C Cohort Study, a prospective cohort involving patients with positive HCV viremia upon inclusion, enrolled in various Swiss centers from September 2000 to November 2021. To examine potential differences in the risk of intrahepatic tumor (IHT) occurrence and death among patients treated with direct-acting antivirals (DAAs), untreated patients, and those receiving interferon (IFN)-based therapy, a semiparametric competing risk proportional hazards regression model was used.
Among 4082 patients (63.1% male, median age 45 years; genotype 1: 54.1%; cirrhosis: 16.1%), 1026 received exclusive treatment with IFN-based regimens, and 1180 were treated solely with DAAs. Over a median follow-up of 7.8 years (range: 3.8-11.9), 179 patients (4.4%) developed intrahepatic tumors (IHT), and 168 (4.1%) experienced extrahepatic tumors (EHT). The 5-year cumulative incidence of IHT was 1.55% (95% CI 0.96-2.48) for IFN-based therapy, 4.27% (95% CI 2.93-6.2) for DAA and 0.89% (95% CI 0.4-1.99) for untreated patients. There was no statistically significant difference in the risk of developing IHT (HR = 1.34; 95% CI = [0.70; 2.58];
= 0.380) or death (HR = 0.66; 95% CI = [0.43; 1.03];
= 0.066) between patients treated with DAAs and those treated with IFN.
The DAAs reduced the risk of death and were not associated with an increased risk of extrahepatic tumors (EHT). In the adjusted model, accounting for cirrhosis and high liver stiffness, the DAA treatment was associated with a higher risk of IHT occurrence compared with untreated patients, emphasizing the relevance of implementing standardized hepatocellular carcinoma (HCC) screening post-DAA treatment.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers16142573</identifier><identifier>PMID: 39061212</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antiviral agents ; Biological response modifiers ; Cancer ; Cancer screening ; Chronic infection ; Cirrhosis ; Clinical medicine ; Complications and side effects ; Death ; Development and progression ; Diagnosis ; Drug therapy ; Genotypes ; Hepatitis C ; Hepatitis C virus ; Hepatocellular carcinoma ; Infections ; Interferon ; Liver ; Liver cancer ; Liver cirrhosis ; Liver diseases ; Malignancy ; Medical research ; Medicine, Experimental ; Morbidity ; Patients ; Protease inhibitors ; Statistical analysis ; Tumors ; Variables ; Viremia ; Virus diseases</subject><ispartof>Cancers, 2024-07, Vol.16 (14), p.2573</ispartof><rights>COPYRIGHT 2024 MDPI AG</rights><rights>2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c387t-1d620d157f7465b642ec34d3c300449adb9bb56b99a41e48925c5afda1c292aa3</cites><orcidid>0000-0003-4562-9016 ; 0000-0001-6346-8362</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39061212$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Radu, Pompilia</creatorcontrib><creatorcontrib>Becchetti, Chiara</creatorcontrib><creatorcontrib>Schropp, Jonas</creatorcontrib><creatorcontrib>Schmid, Patrick</creatorcontrib><creatorcontrib>Künzler-Heule, Patrizia</creatorcontrib><creatorcontrib>Mertens, Joachim</creatorcontrib><creatorcontrib>Moradpour, Darius</creatorcontrib><creatorcontrib>Müllaupt, Beat</creatorcontrib><creatorcontrib>Semela, David</creatorcontrib><creatorcontrib>Negro, Francesco</creatorcontrib><creatorcontrib>Heim, Markus</creatorcontrib><creatorcontrib>Clerc, Olivier</creatorcontrib><creatorcontrib>Roelens, Maroussia</creatorcontrib><creatorcontrib>Keiser, Olivia</creatorcontrib><creatorcontrib>Berzigotti, Annalisa</creatorcontrib><creatorcontrib>Swiss Hepatitis C Cohort Study</creatorcontrib><creatorcontrib>Swiss Hepatitis C Cohort Study</creatorcontrib><title>Effect of Direct Acting Antiviral Drugs on the Occurrence and Recurrence of Intra- and Extra-Hepatic Malignancies in Patients with Chronic Hepatitis C Virus Infection</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>The use of direct-acting antivirals (DAAs) has drastically changed the management of HCV-infected patients by achieving a 95-98% sustained virologic response (SVR) and reducing morbidity and mortality in this population. However, despite their effectiveness, controversy exists concerning the occurrence of oncologic events following DAA therapy.
A retrospective analysis was conducted on data from the Swiss Hepatitis C Cohort Study, a prospective cohort involving patients with positive HCV viremia upon inclusion, enrolled in various Swiss centers from September 2000 to November 2021. To examine potential differences in the risk of intrahepatic tumor (IHT) occurrence and death among patients treated with direct-acting antivirals (DAAs), untreated patients, and those receiving interferon (IFN)-based therapy, a semiparametric competing risk proportional hazards regression model was used.
Among 4082 patients (63.1% male, median age 45 years; genotype 1: 54.1%; cirrhosis: 16.1%), 1026 received exclusive treatment with IFN-based regimens, and 1180 were treated solely with DAAs. Over a median follow-up of 7.8 years (range: 3.8-11.9), 179 patients (4.4%) developed intrahepatic tumors (IHT), and 168 (4.1%) experienced extrahepatic tumors (EHT). The 5-year cumulative incidence of IHT was 1.55% (95% CI 0.96-2.48) for IFN-based therapy, 4.27% (95% CI 2.93-6.2) for DAA and 0.89% (95% CI 0.4-1.99) for untreated patients. There was no statistically significant difference in the risk of developing IHT (HR = 1.34; 95% CI = [0.70; 2.58];
= 0.380) or death (HR = 0.66; 95% CI = [0.43; 1.03];
= 0.066) between patients treated with DAAs and those treated with IFN.
The DAAs reduced the risk of death and were not associated with an increased risk of extrahepatic tumors (EHT). In the adjusted model, accounting for cirrhosis and high liver stiffness, the DAA treatment was associated with a higher risk of IHT occurrence compared with untreated patients, emphasizing the relevance of implementing standardized hepatocellular carcinoma (HCC) screening post-DAA treatment.</description><subject>Antiviral agents</subject><subject>Biological response modifiers</subject><subject>Cancer</subject><subject>Cancer screening</subject><subject>Chronic infection</subject><subject>Cirrhosis</subject><subject>Clinical medicine</subject><subject>Complications and side effects</subject><subject>Death</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Drug therapy</subject><subject>Genotypes</subject><subject>Hepatitis C</subject><subject>Hepatitis C virus</subject><subject>Hepatocellular carcinoma</subject><subject>Infections</subject><subject>Interferon</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Liver diseases</subject><subject>Malignancy</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Morbidity</subject><subject>Patients</subject><subject>Protease inhibitors</subject><subject>Statistical analysis</subject><subject>Tumors</subject><subject>Variables</subject><subject>Viremia</subject><subject>Virus diseases</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptks1vFCEYxomxsU3t2Zsh8eJlWr4GZo6b7Wqb1LRp1OuEYV52aWZhBcaPf8i_U8atVZvCgRf4PQ9PyIvQK0pOOW_JmdHeQExUUsFqxZ-hI0YUq6RsxfN_6kN0ktIdKYNzqqR6gQ6LWlJG2RH6ubIWTMbB4nMX52phsvNrvPDZfXVRj_g8TuuEg8d5A_jamClGKA9j7Qd8Cw_b4nDpc9TV74vV97m8gJ3OzuAPenRrX-I6SNh5fFNOweeEv7m8wctNDL5Qezq7hJf4s4tTKoZzOBf8S3Rg9Zjg5H49Rp_erT4uL6qr6_eXy8VVZXijckUHychAa2WVkHUvBQPDxcANJ0SIVg992_e17NtWCwqiaVltam0HTQ1rmdb8GL3d--5i-DJByt3WJQPjqD2EKXWcNDWlQkla0DeP0LswRV_SzZRQrKGk-Uut9Qid8zaUfzGzabdoCFdSEEoKdfoEVeYAW2eCB-vK-X-Cs73AxJBSBNvtotvq-KOjpJubo3vUHEXx-j7u1G9heOD_tAL_BRq7tSM</recordid><startdate>20240701</startdate><enddate>20240701</enddate><creator>Radu, Pompilia</creator><creator>Becchetti, Chiara</creator><creator>Schropp, Jonas</creator><creator>Schmid, Patrick</creator><creator>Künzler-Heule, Patrizia</creator><creator>Mertens, Joachim</creator><creator>Moradpour, Darius</creator><creator>Müllaupt, Beat</creator><creator>Semela, David</creator><creator>Negro, Francesco</creator><creator>Heim, Markus</creator><creator>Clerc, Olivier</creator><creator>Roelens, Maroussia</creator><creator>Keiser, Olivia</creator><creator>Berzigotti, Annalisa</creator><creator>Swiss Hepatitis C Cohort Study</creator><general>MDPI AG</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PIMPY</scope><scope>PKEHL</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4562-9016</orcidid><orcidid>https://orcid.org/0000-0001-6346-8362</orcidid></search><sort><creationdate>20240701</creationdate><title>Effect of Direct Acting Antiviral Drugs on the Occurrence and Recurrence of Intra- and Extra-Hepatic Malignancies in Patients with Chronic Hepatitis C Virus Infection</title><author>Radu, Pompilia ; Becchetti, Chiara ; Schropp, Jonas ; Schmid, Patrick ; Künzler-Heule, Patrizia ; Mertens, Joachim ; Moradpour, Darius ; Müllaupt, Beat ; Semela, David ; Negro, Francesco ; Heim, Markus ; Clerc, Olivier ; Roelens, Maroussia ; Keiser, Olivia ; Berzigotti, Annalisa ; Swiss Hepatitis C Cohort Study</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-1d620d157f7465b642ec34d3c300449adb9bb56b99a41e48925c5afda1c292aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Antiviral agents</topic><topic>Biological response modifiers</topic><topic>Cancer</topic><topic>Cancer screening</topic><topic>Chronic infection</topic><topic>Cirrhosis</topic><topic>Clinical medicine</topic><topic>Complications and side effects</topic><topic>Death</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Drug therapy</topic><topic>Genotypes</topic><topic>Hepatitis C</topic><topic>Hepatitis C virus</topic><topic>Hepatocellular carcinoma</topic><topic>Infections</topic><topic>Interferon</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Liver diseases</topic><topic>Malignancy</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Morbidity</topic><topic>Patients</topic><topic>Protease inhibitors</topic><topic>Statistical analysis</topic><topic>Tumors</topic><topic>Variables</topic><topic>Viremia</topic><topic>Virus diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Radu, Pompilia</creatorcontrib><creatorcontrib>Becchetti, Chiara</creatorcontrib><creatorcontrib>Schropp, Jonas</creatorcontrib><creatorcontrib>Schmid, Patrick</creatorcontrib><creatorcontrib>Künzler-Heule, Patrizia</creatorcontrib><creatorcontrib>Mertens, Joachim</creatorcontrib><creatorcontrib>Moradpour, Darius</creatorcontrib><creatorcontrib>Müllaupt, Beat</creatorcontrib><creatorcontrib>Semela, David</creatorcontrib><creatorcontrib>Negro, Francesco</creatorcontrib><creatorcontrib>Heim, Markus</creatorcontrib><creatorcontrib>Clerc, Olivier</creatorcontrib><creatorcontrib>Roelens, Maroussia</creatorcontrib><creatorcontrib>Keiser, Olivia</creatorcontrib><creatorcontrib>Berzigotti, Annalisa</creatorcontrib><creatorcontrib>Swiss Hepatitis C Cohort Study</creatorcontrib><creatorcontrib>Swiss Hepatitis C Cohort Study</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Cancers</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Radu, Pompilia</au><au>Becchetti, Chiara</au><au>Schropp, Jonas</au><au>Schmid, Patrick</au><au>Künzler-Heule, Patrizia</au><au>Mertens, Joachim</au><au>Moradpour, Darius</au><au>Müllaupt, Beat</au><au>Semela, David</au><au>Negro, Francesco</au><au>Heim, Markus</au><au>Clerc, Olivier</au><au>Roelens, Maroussia</au><au>Keiser, Olivia</au><au>Berzigotti, Annalisa</au><au>Swiss Hepatitis C Cohort Study</au><aucorp>Swiss Hepatitis C Cohort Study</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Direct Acting Antiviral Drugs on the Occurrence and Recurrence of Intra- and Extra-Hepatic Malignancies in Patients with Chronic Hepatitis C Virus Infection</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2024-07-01</date><risdate>2024</risdate><volume>16</volume><issue>14</issue><spage>2573</spage><pages>2573-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>The use of direct-acting antivirals (DAAs) has drastically changed the management of HCV-infected patients by achieving a 95-98% sustained virologic response (SVR) and reducing morbidity and mortality in this population. However, despite their effectiveness, controversy exists concerning the occurrence of oncologic events following DAA therapy.
A retrospective analysis was conducted on data from the Swiss Hepatitis C Cohort Study, a prospective cohort involving patients with positive HCV viremia upon inclusion, enrolled in various Swiss centers from September 2000 to November 2021. To examine potential differences in the risk of intrahepatic tumor (IHT) occurrence and death among patients treated with direct-acting antivirals (DAAs), untreated patients, and those receiving interferon (IFN)-based therapy, a semiparametric competing risk proportional hazards regression model was used.
Among 4082 patients (63.1% male, median age 45 years; genotype 1: 54.1%; cirrhosis: 16.1%), 1026 received exclusive treatment with IFN-based regimens, and 1180 were treated solely with DAAs. Over a median follow-up of 7.8 years (range: 3.8-11.9), 179 patients (4.4%) developed intrahepatic tumors (IHT), and 168 (4.1%) experienced extrahepatic tumors (EHT). The 5-year cumulative incidence of IHT was 1.55% (95% CI 0.96-2.48) for IFN-based therapy, 4.27% (95% CI 2.93-6.2) for DAA and 0.89% (95% CI 0.4-1.99) for untreated patients. There was no statistically significant difference in the risk of developing IHT (HR = 1.34; 95% CI = [0.70; 2.58];
= 0.380) or death (HR = 0.66; 95% CI = [0.43; 1.03];
= 0.066) between patients treated with DAAs and those treated with IFN.
The DAAs reduced the risk of death and were not associated with an increased risk of extrahepatic tumors (EHT). In the adjusted model, accounting for cirrhosis and high liver stiffness, the DAA treatment was associated with a higher risk of IHT occurrence compared with untreated patients, emphasizing the relevance of implementing standardized hepatocellular carcinoma (HCC) screening post-DAA treatment.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>39061212</pmid><doi>10.3390/cancers16142573</doi><orcidid>https://orcid.org/0000-0003-4562-9016</orcidid><orcidid>https://orcid.org/0000-0001-6346-8362</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2072-6694 |
| ispartof | Cancers, 2024-07, Vol.16 (14), p.2573 |
| issn | 2072-6694 2072-6694 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3085114761 |
| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Antiviral agents Biological response modifiers Cancer Cancer screening Chronic infection Cirrhosis Clinical medicine Complications and side effects Death Development and progression Diagnosis Drug therapy Genotypes Hepatitis C Hepatitis C virus Hepatocellular carcinoma Infections Interferon Liver Liver cancer Liver cirrhosis Liver diseases Malignancy Medical research Medicine, Experimental Morbidity Patients Protease inhibitors Statistical analysis Tumors Variables Viremia Virus diseases |
| title | Effect of Direct Acting Antiviral Drugs on the Occurrence and Recurrence of Intra- and Extra-Hepatic Malignancies in Patients with Chronic Hepatitis C Virus Infection |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T18%3A40%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effect%20of%20Direct%20Acting%20Antiviral%20Drugs%20on%20the%20Occurrence%20and%20Recurrence%20of%20Intra-%20and%20Extra-Hepatic%20Malignancies%20in%20Patients%20with%20Chronic%20Hepatitis%20C%20Virus%20Infection&rft.jtitle=Cancers&rft.au=Radu,%20Pompilia&rft.aucorp=Swiss%20Hepatitis%20C%20Cohort%20Study&rft.date=2024-07-01&rft.volume=16&rft.issue=14&rft.spage=2573&rft.pages=2573-&rft.issn=2072-6694&rft.eissn=2072-6694&rft_id=info:doi/10.3390/cancers16142573&rft_dat=%3Cgale_proqu%3EA803764010%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3084728108&rft_id=info:pmid/39061212&rft_galeid=A803764010&rfr_iscdi=true |