Low Incidence of Hepatocellular Carcinoma after Antiviral Therapy in Patients with Chronic Hepatitis C and Hemophilia
- Authors
- Kim, I.J.; Yoo, S.H.; Kim, S.; Cho, Y.Y.; Yoo, K.Y.; Kim, H.J.; Lee, H.W.
- Issue Date
- Mar-2022
- Publisher
- MDPI
- Keywords
- Chronic hepatitis C; Hemophilia; Hepatocellular carcinoma
- Citation
- Journal of Clinical Medicine, v.11, no.5
- Journal Title
- Journal of Clinical Medicine
- Volume
- 11
- Number
- 5
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/56725
- DOI
- 10.3390/jcm11051451
- ISSN
- 2077-0383
2077-0383
- Abstract
- Background: Hepatocellular carcinoma (HCC) rarely develops in patients with chronic hepatitis C (CHC) who achieve sustained virological response (SVR). We assessed the incidence of HCC in CHC patients with hemophilia after treatment with pegylated interferon plus ribavirin (PegIFN/RBV) and direct-acting antivirals (DAAs). Methods: Patients (n = 202) were enrolled between March 2007 and July 2019. A total of 139 patients were treated with PegIFN/RBV (genotype 1, n = 98; genotype 2, n = 41). Sixty-three patients were treated with DAAs (genotype 1, n = 44; genotype 2, n = 19). The cumulative incidence rates of HCC were estimated using the Kaplan–Meier method and compared using the log-rank test. Results: For genotype 1, SVR was achieved in 78.6% (77/98) and 90.9% (40/44) of patients in the PegIFN/RBV and DAAs groups, respectively. For genotype 2, SVR was achieved in 95.1% (39/41) and 94.7% (18/19) of patients in the PegIFN/RBV and DAAs groups, respectively. Six HCC cases were identified. The cumulative incidence of HCC was 4.1% at 14 years in PegIFN/RBV and 1.7% at 5 years in DAAs. The 14-year cumulative incidence of HCC was 1.9% in the SVR group and 21.7% in the no-SVR group in the PegIFN/RBV group (p < 0.001). Conclusions: Treatment with PegIFN/RBV led to stable SVR and a low incidence of HCC. Although the follow-up period was short, DAAs led to more stable SVR than PegIFN/RBV and a low incidence of HCC in CHC patients with hemophilia. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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