At the 2017 annual meeting of the American Liver Disease Association, a large observational study reported that the use of direct antiviral (DAA) therapy to eradicate hepatitis C virus (HCV) can reduce the risk of liver cancer by 71%. In patients with cirrhosis and non-cirrhosis, the risk of liver cancer is reduced. In the United States, most primary liver cancer occurs in people infected with HCV. Researchers at the University of Washington hypothesized that the eradication of HCV could eliminate or at least significantly reduce the risk of 肝臓がん. However, before HCV eradication, the patient may have developed cirrhosis or liver fibrosis. Even if HCV eradication may be too late, there is still a risk of developing liver cancer. In addition, recent studies suggest that the risk of liver cancer in HCV-infected patients who have received new DAA treatment is still increased. The researchers analyzed 62,051 patients with HCV infection who received 83,695 antiviral treatments. After 180 days of antiviral treatment, an average of 3,271 new liver cancers occurred during a follow-up of 6.1 years. Patients with cirrhosis who failed treatment had the highest incidence of liver cancer (3.25 / 100 person-years), followed by patients with cirrhosis who had sustained virological response (SVR) (1.97 / 100 person-years), and patients who had no cirrhosis but failed treatment (0.87 / 100 person-years) and patients without cirrhosis who obtained SVR (0.24 / 100 person-years). Multivariate analysis showed that after adjusting for potential confounders, SVR was significantly associated with a lower risk of liver cancer, regardless of whether DAA treatment (aHR = 0.29), DAA combined with interferon treatment (aHR = 0.48), or interferon only treatment (aHR = 0.32).
研究者らは、昨年の欧州肝疾患会議での研究で、DAAで治療を受けたHCV患者は肝がんの再発率が高いようであることが示唆されたと強調している。 HCV と肝臓がんの関係は、HCV の根絶によって肝臓がんのリスクが減少するはずであり、肝臓がんのリスクが増加するわけではないことを示唆しているため、この結果は非常に物議を醸しています。この観察研究の結論は、HCV の DAA 除菌により肝臓がんのリスクを 71% 低減できるという非常に確実な結論であり、HCV の除菌によって肝臓がんのリスクが高まることを心配する必要はないことを示唆しています。 HCV を根絶することで肝臓がんのリスクを軽減します。
