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 raka na jetrih. 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).
Raziskovalci poudarjajo, da je lanskoletna študija na Evropskem kongresu o boleznih jeter pokazala, da imajo bolniki s HCV, zdravljeni z DAA, višjo stopnjo ponovitve raka jeter. Ta rezultat je zelo sporen, saj razmerje med HCV in rakom na jetrih nakazuje, da bi moralo izkoreninjenje HCV zmanjšati tveganje za nastanek raka na jetrih in ne povečati tveganja za raka na jetrih. Zaključek te opazovalne študije je zelo gotov, da lahko izkoreninjenje HCV z DAA zmanjša tveganje za raka na jetrih za 71 %, kar nakazuje, da ni treba skrbeti, da bi izkoreninjenje HCV povečalo tveganje za raka na jetrih. Izkoreninjenje HCV je zmanjšanje tveganja raka jeter.
