The impact of the revolution in hepatitis C treatment on hepatocellular carcinoma

• Published in: Annals of oncology Vol. 27; no. 8; pp. 1467 - 1474
• Main Authors: Wirth, T.C., Manns, M.P.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-08-2016
• Subjects: Antiviral Agents - therapeutic use; antiviral therapy; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - virology; cirrhosis; Clinical Trials as Topic; decompensated liver function; Hepacivirus - pathogenicity; hepatitis C; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C - epidemiology; Hepatitis C - virology; hepatocellular carcinoma; Humans; Liver - pathology; Liver - virology; Liver Neoplasms - complications; Liver Neoplasms - drug therapy; Liver Neoplasms - epidemiology; Liver Neoplasms - virology; liver transplantation; decompensated liver function; hepatitis C; antiviral therapy; hepatocellular carcinoma; liver transplantation; cirrhosis
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdw219

Hepatitis C infection represents a global health problem affecting ∼200 million chronically infected patients worldwide. Owing to the development of a fibrogenic and inflammatory micromilieu in the liver, hepatitis C virus (HCV)-infected patients are at a high risk of developing fibrosis, cirrhosis and hepatocellular carcinoma (HCC). The advent of direct-acting antiviral agents (DAAs), however, has spurred a revolution in the treatment of HCV patients with sustained viral response (SVR) rates exceeding 90% in real-life settings. Recent clinical trials suggest that these novel treatments will not only alter the epidemiology of HCV infection but also the incidence of HCV-induced complications including hepatic decompensation, liver transplantation and hepatocarcinogenesis. Here, we summarize data from clinical trials carried out in HCV patients with compensated and decompensated cirrhosis and analyze the impact of viral clearance on HCC development and treatment. Finally, we review and discuss current and future treatment options of HCV patients with HCC in pre- and post-transplantation settings.