Wednesday, November 18, 2015

AASLD 2015 - The Risk of Developing Liver Cancer Even After Being Cured from Hepatitis C

The Risk of Developing Liver Cancer Even After Being Cured from Hepatitis C

SAN FRANCISCO, Nov. 15, 2015 /PRNewswire/ -- Hepatocellular carcinoma (HCC) remains one of the cancers growing in frequency and mortality in the United States. Patients with hepatitis C virus (HCV) left untreated will often progress to cirrhosis and HCC. Direct acting antivirals (DAAs) now used to treat patients with HCV have achieved almost universal cure rates. However, the risk of HCC following cure is not clear. Researchers from Houston VA Medical Center and Baylor College of Medicine (Houston, TX) presented data at the annual meeting of the American Association for the Study of Liver Diseases on the risk of developing HCC in patients with HCV who have achieved sustained virologic response (SVR).

This retrospective national cohort study examined the records of patients who achieved SVR using interferon-based therapy and who had at least one year of follow up in the national VA system. There were 10,738 patients who achieved SVR and had no HCC prior to SVR. Of those patients who achieved SVR, 100 developed HCC after SVR.

Dr. El-Serag, the study's principal investigator, concluded that the risk of developing HCC after being cured of HCC remains elevated with an overall incidence of 0.33 percent per year. Being older, or having cirrhosis at the time of SVR were associated with annual HCC risk of 0.9% and 1.55%, respectively. Diabetes and previous genotype 3 were also associated with an additional increased risk of developing HCC after HCV cure. Dr. El-Serag addresses those at an increased risk of developing HCC, "Subgroups such as age 65 years and older, those with diabetes and especially those with cirrhosis have even higher rates -- closer to or higher than 1 percent per year -- of developing HCC."

"The results pertain to mostly male veterans treated with interferon-based treatments and therefore may not be generalizable to women, nonveterans and those cured using DAA," cautioned Dr. El-Serag. He added, "We still need to examine large cohorts of DAA-cured patients, and examine several demographic, clinical, and genetic factors that may serve as predictor or prognostic markers.

When asked to address the overall significance of this study, Dr. El-Serag replied, "We will be facing large numbers of cured HCV patients and this study gives us a glimpse what the clinical course might be. It is clear that while cure considerably reduces HCC risk in general, it does not eliminate it especially when cirrhosis is present and in those who get cured at an old age. Therefore, the sooner we cure patients the better off we are. Furthermore continued vigilance and HCC surveillance is warranted after cure in these subgroups."

Abstract title: Incidence and predictors of hepatocellular carcinoma following sustained virological response: A national cohort study

AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD's vision is to prevent and cure liver diseases. This year's Liver Meeting®, held in San Francisco, CA, November 14-17, will bring together more than 9,000 researchers from 55 countries.

A pressroom will be available from November 13 at the annual meeting. For copies of abstracts and press releases, or to arrange researcher interviews, contact Gregory Bologna at 703-299-9766.

Press releases and all abstracts are available online at

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