DAAs Cut Deaths in Those Treated for HCV-Related Liver Cancer

Among patients with hepatitis C virus (HCV) infection and complete response to hepatocellular carcinoma (HCC) treatment, direct-acting antiviral (DAA) therapy is associated with a significant reduction in the risk for death, according to a study published online in Gastroenterology.

Amit G. Singal, M.D., from the UT Southwestern Medical Center in Dallas, and colleagues compared overall survival between patients with HCV infection treated with DAAs versus patients who did not receive DAA treatment for their HCV infection after complete response to prior HCC therapy (resection, local ablation, transarterial chemoembolization or radioembolization, or radiation therapy). The analysis included 797 patients treated (2013 through 2017) at 31 health care systems throughout the United States and Canada.

The researchers found that 48.1 percent of patients received DAA therapy and 51.9 percent did not receive treatment for their HCV infection after complete response to prior HCC therapy. Forty-three deaths occurred among DAA-treated patients during 941 person-years of follow-up versus 103 deaths during 526.6 person-years of follow-up among patients who did not receive DAA therapy (crude rate ratio, 0.23; 95 percent confidence interval [CI], 0.16 to 0.33). DAA therapy was associated with a significant reduction in the risk for death (hazard ratio [HR], 0.54; 95 percent CI, 0.33 to 0.90) in inverse probability-weighted analyses. Risk for death was reduced in patients with a sustained virologic response to DAA therapy (HR, 0.29; 95 percent CI, 0.18 to 0.47), but not in patients without a sustained virologic response (HR, 1.13; 95 percent CI, 0.55 to 2.33).

"Not only are these drugs safe in this patient population, but we have now demonstrated that they are helpful," said Singal in a statement. "Our study changes the paradigm from you could treat a patient's hepatitis C to you should treat it."

Several authors disclosed financial ties to pharmaceutical companies, including Abbvie, which partially funded the study.

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