Portal de Periódicos da CAPES

Hepatocellular carcinoma after sustained virological response with interferon-free regimens in HIV/hepatitis C virus-coinfected patients

2018; Lippincott Williams & Wilkins; Volume: 32; Issue: 11 Linguagem: Inglês

10.1097/qad.0000000000001809

1473-5571

Nicolás Merchante, Francisco Rodríguez-Arrondo, Boris Revollo, Esperanza Merino, Sofía Ibarra, Marı́a José Galindo, Marta Montero, Miguel García Deltoro, Antonio Rivero‐Juárez, Francisco Téllez, Marcial Delgado‐Fernández, Maria José Ríos-Villegas, M.Á. Bonillo García, Francisco Jesús Vera-Méndez, Guillermo Ojeda, Miguel Ángel López‐Ruz, Luís Metola, Mohamed Omar, María Remedios Alemán Valls, Koldo Aguirrebengoa, Joseba Portu, Miguel Raffo, Juan Macı́as, Juan A. Pineda,

Hepatitis B Virus Studies

Objective: To assess the possible association between the use of direct antiviral agents (DAA) and the risk of hepatocellular carcinoma (HCC) in HIV/hepatitis C virus (HCV)-coinfected patients. Methods: The GEHEP-002 cohort recruits HCC cases in HIV-infected patients from 32 centers from Spain. Three analyses were performed: the proportion of HCC cases after sustained virological response (SVR) and the evolution of this proportion over time, the frequency of HCC after SVR in HIV/HCV-coinfected patients with cirrhosis, and the probability of HCC recurrence after curative therapies among those undergoing HCV therapy. Results: Forty-two (13%) out of 322 HCC cases in HIV/HCV-coinfected patients occurred after SVR. Twenty-eight (10%) out of 279 HCC cases diagnosed during the years of use of IFN-based regimens occurred after SVR whereas this occurred in 14 (32.6%) out of the 43 HCC cases diagnosed in the all-oral DAA period (P < 0.0001). One thousand, three hundred and thirty-seven HIV/HCV-coinfected patients with cirrhosis achieved SVR in the cohort. The frequency of HCC after SVR declined from 15% among those cured with pegylated-IFN with ribavirin to 1.62 and 0.87% among those cured with DAA with and without IFN, respectively. In patients with previous HCC treated with curative therapies, HCC recurrence occurred in two (25%) out of eight patients treated with IFN-based regimens and four (21%) out of 19 treated with DAA-IFN-free regimens (P = 1.0). Conclusion: The frequency of HCC emergence after SVR has not increased after widespread use of DAA in HIV/HCV-coinfected patients. DAA do not seem to impact on HCC recurrence in the short-term among those with previously treated HCC.