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Independent Risk Factors for Hepatocellular Carcinoma Recurrence after Direct-Acting Antiviral Therapy in Patients with Chronic Hepatitis C

 Young-Hwan Ahn  ;  Heirim Lee  ;  Do Young Kim  ;  Hye Won Lee  ;  Su Jong Yu  ;  Young Youn Cho  ;  Jeong Won Jang  ;  Byoung Kuk Jang  ;  Chang Wook Kim  ;  Hee Yeon Kim  ;  Hana Park  ;  Hyo Jung Cho  ;  Bumhee Park  ;  Soon Sun Kim  ;  Jae Youn Cheong 
 GUT AND LIVER, Vol.15(3) : 410-419, 2021-05 
Journal Title
Issue Date
Antiviral agents ; Carcinoma ; Hepatitis C ; Recurrence ; Risk factors ; chronic ; hepatocellular
Background/aims: This study was performed to evaluate the efficacy of direct-acting antivirals (DAAs) in Korean patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) and to investigate the risk factors associated with HCC recurrence.

Methods: A total of 100 patients with HCV-related HCC, who were treated with DAAs between May 2015 and December 2016, were recruited from seven university hospitals in Korea. Claim data of 526 patients with HCC obtained from the Health Insurance Review and Assessment Service in South Korea were used for external validation of the results.

Results: Among the 100 patients, 88% achieved a sustained virological response (SVR) 12 weeks after the end of DAA therapy (SVR12), and 37% experienced HCC recurrence after DAA therapy. Short last HCC treatment durability (<12 months) before DAA commencement was independently associated with HCC recurrence (hazard ratio [HR], 2.89; p=0.011). In the nationwide validation cohort, 20.3% of the patients experienced HCC recurrence. The last HCC treatment with a noncurative method, a short last HCC treatment durability (<12 months), and a longer total duration of HCC treatment (≥18 months) were independently related with HCC recurrence (HR 3.73, p<0.001; HR 3.34, p<0.001; and HR 1.74, p=0.006; respectively).

Conclusions: DAA therapy showed an acceptable SVR12 rate in patients with HCV-related HCC. Short last HCC treatment durability (<12 months) was associated with HCC recurrence after DAA therapy. This finding suggests that the last HCC treatment durability is an important predictor of HCC recurrence after DAA therapy.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
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