The impact of different antiviral therapy on the development of hepatocellular carcinoma in patients with chronic hepatitis C

Abstract

Abstract: Objective To compare the occurrence of hepatocellular carcinoma in patients with chronic hepatitis C who achieved sustained virologic response after direct-acting antiviral agents (DAAs) or pegylated interferon combined with ribavirin (PR regimen), and to analyze the risk factors for developing hepatocellular carcinoma. Methods We retrospectively analyzed the clinical data of patients with chronic hepatitis C who met the inclusion criteria at the Third Hospital of Hebei Medical University from January 2006. Patients were divided into the DAAs group and the PR group based on the treatment regimens. Propensity Scores Matching was utilized to mitigate the confounding bias between the two groups. The Kaplan-Meier method was employed to estimate the incidience rate, and the Log-rank test was used to assess the differences. Cox proportional hazard regression analysis was conducted to identify the risk factors for HCC occurence. Results A total of 369 patients were enrolled, with 229 (62.1%) patients receiving PR regimen and 140 (37.9%) patients receiving DAAs. After propensity matching, 106 patients in each group were further analyzed. The 4-year incidence of hepatocellular carcinoma in the two groups was 7.9% and 10.2% respectively, with no statistical significance (P=0.070). Multivariate analysis revealed that age at the initiation of treatment (HR=1.093, 95%CI: 1.007, 1.186), diabetes mellitus (HR=9.988, 95%CI: 2.093, 47.662), liver cirrhosis (HR=9.422, 95%CI: 1.079, 82.250), baseline AFP ≥10 ng/mL (HR=5.683, 95%CI: 1.100, 29.369), and high HCV RNA level (HR=2.877, 95%CI: 1.203, 6.878) were independent predictors of HCC occurence in patients with chronic hepatitis C who achieved sustained virologic response. Conclusion There was no significant difference in the 4-year incidence of hepatocellular carcinoma in patients with sustained virologic response to different antiviral treatment regimens.

Key words: Chronic hepatitis C, Hepatocellular carcinoma, Direct antiviral agents, Peg-interferon, Sustained virologic response

ZHAO Ya-lin, SHEN Chuan, WEI Meng-ping, ZHAO Cai-yan. The impact of different antiviral therapy on the development of hepatocellular carcinoma in patients with chronic hepatitis C[J]. Chinese Hepatolgy, 2024, 29(2): 182-188.

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