Hepatitis C Virus Cure Rates Are Reduced in Patients With Active but Not Inactive Hepatocellular Carcinoma: A Practice Implication
- Authors
- Ogawa, Eiichi; Toyoda, Hidenori; Iio, Etsuko; Jun, Dae Won; Huang, Chung-Feng; Enomoto, Masaru; Hsu, Yao-Chun; Haga, Hiroaki; Iwane, Shinji; Wong, Grace; Lee, Dong Hyun; Tada, Toshifumi; Liu, Chen-Hua; Chuang, Wan-Long; Hayashi, Jun; Cheung, Ramsey; Yasuda, Satoshi; Tseng, Cheng-Hao; Takahashi, Hirokazu; Tran, Sally; Yeo, Yee Hui; Henry, Linda; Barnett, Scott D.; Nomura, Hideyuki; Nakamuta, Makoto; Dai, Chia-Yen; Huang, Jee-Fu; Yang, Hwai-, I; Lee, Mei-Hsuan; Jun, Mi Jung; Kao, Jia-Horng; Eguchi, Yuichiro; Ueno, Yoshiyuki; Tamori, Akihiro; Furusyo, Norihiro; Yu, Ming-Lung; Tanaka, Yasuhito; Nguyen, Mindie H.
- Issue Date
- Dec-2020
- Publisher
- OXFORD UNIV PRESS INC
- Keywords
- hepatitis C virus; hepatocellular carcinoma; direct-acting antivirals; Asian; propensity score matching
- Citation
- CLINICAL INFECTIOUS DISEASES, v.71, no.11, pp.2840 - 2848
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL INFECTIOUS DISEASES
- Volume
- 71
- Number
- 11
- Start Page
- 2840
- End Page
- 2848
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/8165
- DOI
- 10.1093/cid/ciz1160
- ISSN
- 1058-4838
- Abstract
- Background. Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCC patients.
Methods. Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCC patients.
Results. We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = .03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC.
Conclusions. Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCC patients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCC patients.
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