Of patients with hepatocellular carcinoma (HCC) and hepatitis C virus, about 75% can achieve virologic cure with direct-acting antiviral (DAA) drugs. In addition, more than 90% of HCC patients who have had a liver transplant can be cured of their HCV infection, according to a new study.
Treatment of HCV in patients with HCC was uncommon before the advent of DAA medications. Moreover, the real-world effectiveness of DAA use in this population has remained unclear. Researchers at the University of Washington, in Seattle, set out to study rates of sustained virologic response (SVR) for DAAs in U.S. veterans with a history of HCC (J Hepatol 2017 Mar 3. [Epub ahead of print]).
“The timing of hepatitis C virus treatment in patients with hepatocellular carcinoma is influenced by a lot of different factors—for example, the presence of cirrhosis, the status of the cancer, whether a patient is a liver transplant candidate,” said Lauren Beste, MD, of Veterans Affairs Puget Sound Health Care System and the study’s lead author. “The HCC population is one of the few groups left where there is truly uncertainty about when to offer hepatitis C treatment.”
“One of our key findings,” Dr. Beste said, “was that post-transplant patients with a history of HCC do extremely well with hepatitis C treatment, at least from the standpoint of getting cured of the virus. For HCC patients who are listed for transplant, it may well make sense to wait until post-transplant to treat their hepatitis C in order to maximize their chances for a cure.”