Could DAA Treatment Raise Short-Term HCC Risk?

July 12, 2018

The use of direct-acting antiviral (DAA) agents for the treatment of chronic hepatitis C virus (HCV) infection is not associated with a short-term increased risk of hepatocellular carcinoma (HCC) among patients who also have cirrhosis, according to new research.

These findings arose from a study of 17,836 individuals who were treated with DAAs or interferon (IFN)-based regimens. Patient data were collected from the Electronically Retrieved Cohort of HCV Infected Veterans database.

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Of the participants, 96.2% of those treated with DAAs achieved sustained virologic response (SVR) compared with 66.6% of those treated with IFN-based regimens.

Ultimately, the researchers found that participants treated with DAAs did not have a higher risk for HCC than those who were treated with IFN-based regimens (hazard ratio 1.07).

Findings from the study did not indicate any between-group differences in the rate of HCC incidence or HCC-free survival among individuals with cirrhosis who achieved SVR (21.2 vs 22.8 per 1000 person-years for the DAA and IFN groups, respectively).

However, a significantly higher HCC incidence rate was observed among untreated participants with cirrhosis (45.3 per 1000 person-years) compared with participants treated with DAAs or IFN-based regimens.

“DAA treatment is not associated with a higher risk of HCC in persons with cirrhosis with chronic HCV infection in the short term,” the researchers concluded.

“Previously reported higher rates of HCC associated with DAA treatment may be explained by both the presence of relatively fewer baseline HCC risk factors in persons treated with IFN as well as selection bias, given that DAA regimens were used to treat persons at higher risk for developing HCC,” they wrote.

—Christina Vogt


Li DK, Ren Y, Fierer DS, et al. The short‐term incidence of hepatocellular carcinoma is not increased after hepatitis C treatment with direct‐acting antivirals: An ERCHIVES study. Hepatology. 2018;67(6):2244-2253. https://doi.org/10.1002/hep.29707